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Medicaid Provider Screening Accountability Act

4/2/2025, 3:30 PM

Summary of Bill HR 1875

Bill 119 hr 1875, also known as the "Medicaid Provider Screening Enhancement Act," aims to make changes to the Medicaid program under title XIX of the Social Security Act. The main goal of this bill is to enhance the screening process for providers who participate in the Medicaid program.

Currently, Medicaid providers undergo a screening process to ensure they meet certain qualifications and standards before they can participate in the program. This bill seeks to strengthen this screening process by requiring additional screening measures for certain providers.

Specifically, the bill mandates that providers who have been terminated from the Medicaid program in the past must undergo more rigorous screening before they can be reinstated. This is intended to prevent providers with a history of misconduct or fraud from re-entering the program and potentially harming Medicaid beneficiaries. Additionally, the bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a process for conducting background checks on Medicaid providers. This will help identify providers with a history of criminal activity or other disqualifying factors. Overall, the Medicaid Provider Screening Enhancement Act aims to improve the integrity of the Medicaid program by ensuring that only qualified and trustworthy providers are able to participate. This will help protect Medicaid beneficiaries and taxpayer dollars from fraud, abuse, and substandard care.

Congressional Summary of HR 1875

Medicaid Provider Screening Accountability Act

This bill requires state Medicaid programs to check, as part of the provider enrollment and reenrollment process, whether providers were terminated from participating in the Medicare program, any other state Medicaid program, or the Children's Health Insurance Program (CHIP) using certain databases (e.g., the Data EXchange system). The bill requires states to continue to check these databases on at least a monthly basis after providers are enrolled.

Current Status of Bill HR 1875

Bill HR 1875 is currently in the status of Bill Introduced since March 5, 2025. Bill HR 1875 was introduced during Congress 119 and was introduced to the House on March 5, 2025.  Bill HR 1875's most recent activity was Referred to the House Committee on Energy and Commerce. as of March 5, 2025

Bipartisan Support of Bill HR 1875

Total Number of Sponsors
4
Democrat Sponsors
0
Republican Sponsors
4
Unaffiliated Sponsors
0
Total Number of Cosponsors
2
Democrat Cosponsors
1
Republican Cosponsors
1
Unaffiliated Cosponsors
0

Policy Area and Potential Impact of Bill HR 1875

Primary Policy Focus

Health

Alternate Title(s) of Bill HR 1875

To amend title XIX of the Social Security Act to require certain additional provider screening under the Medicaid program.To amend title XIX of the Social Security Act to require certain additional provider screening under the Medicaid program.

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