Sec. 102. Reforming how CMS tracks and corrects the vulnerabilities identified by Recovery Audit Contractors
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Section 1893(h) of the Social Security Act ( 42 U.S.C. 1395ddd(h) ) is amended— in paragraph (8)— by striking and inserting “ report .—The Secretary report .— Subject to subparagraph (C), the Secretary ; and by adding after subparagraph (A), as inserted by subparagraph (A), the following new subparagraphs: Each report submitted under subparagraph
(A)shall, subject to subparagraph (C), include— a description of— the types and financial cost to the program under this title of improper payment vulnerabilities identified by recovery audit contractors under this subsection; and how the Secretary is addressing such improper payment vulnerabilities; and an assessment of the effectiveness of changes made to payment policies and procedures under this title in order to address the vulnerabilities so identified. The Secretary shall ensure that each report submitted under subparagraph
(A)does not include information that the Secretary determines would be sensitive or would otherwise negatively impact program integrity. ; and by adding at the end the following new paragraph: The Secretary shall address improper payment vulnerabilities identified by recovery audit contractors under this subsection in a timely manner, prioritized based on the risk to the program under this title. . Section 1893(h)(1)(C) of the Social Security Act (42 U.S.C. 1395ddd(h)(1)(C)) is amended— by striking the Secretary shall retain and inserting “the Secretary— shall retain ; in clause (i), as added by subparagraph (A)— by inserting , in addition to any other funds that may be available, after available ; by inserting until expended after Services ; and by striking the period at the end and inserting a semicolon; and by adding at the end the following new clauses: may retain an additional portion of the amounts recovered (not to exceed 25 percent of such amounts recovered) which shall be available, in addition to any other funds that may be available, to such program management account until expended for purposes of activities to address problems that contribute to improper payments and fraud under this title; and shall retain an additional 5 percent of such amounts recovered to be made available, in addition to any other funds that may be available, to the Inspector General of the Department of Health and Human Services until expended for the Inspector General to carry out activities of the Inspector General relating to investigating improper payments or auditing internal controls associated with payments under this title. . Section 1936 of the Social Security Act (42 U.S.C. 1396u–6) is amended by adding at the end the following new subsection: Notwithstanding any other provision of law, the Secretary— may retain a portion of the amounts recovered pursuant to the program established under section 1902(a)(42)(B) (not to exceed 25 percent of the Federal share of such amounts recovered) which shall be available, in addition to any other funds that may be available, to the program management account of the Centers for Medicare & Medicaid Services for purposes of activities to address problems that contribute to improper payments and fraud under this title; and shall retain an additional 5 percent of the Federal share of such amounts recovered to be made available, in addition to any other funds that may be available, to the Inspector General of the Department of Health and Human Services until expended for the Inspector General to carry out activities of the Inspector General relating to investigating improper payments or auditing internal controls associated with payments under this title. . The amendments made by this section shall take effect on January 1, 2014.
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- 42 USC 1396u–6
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Sec. 102
Reforming how CMS tracks and corrects the vulnerabilities identified by Recovery Audit Contractors
Cite42 USC 1396u–6
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