Sec. 202. Improving the sharing of data between the Federal Government and State Medicaid programs
357 words·~2 min read·
/bill/113/s/1123/is/section-202A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Secretary of Health and Human Services (in this section referred to as the Secretary ) shall establish a plan to encourage and facilitate the participation of States in the Medicare-Medicaid Data Match Program (commonly referred to as the Medi-Medi Program ) under section 1893(g) of the Social Security Act ( 42 U.S.C. 1395ddd(g) ). Section 1893(g)(1)(A) of the Social Security Act (42 U.S.C. 1395ddd(g)(1)(A)) is amended— in the matter preceding clause (i), by inserting or otherwise after eligible entities ; in clause (i)— by inserting to review claims data after algorithms ; and by striking service, time, or patient and inserting provider, service, time, or patient ; in clause (ii)— by inserting to investigate and recover amounts with respect to suspect claims after appropriate actions ; and by striking ; and and inserting a semicolon; in clause (iii), by striking the period and inserting ; and ; and by adding at end the following new clause: furthering the Secretary’s design, development, installation, or enhancement of an automated data system architecture— to collect, integrate, and assess data for purposes of program integrity, program oversight, and administration, including the Medi-Medi Program; and that improves the coordination of requests for data from States. .
The Secretary shall develop and implement a plan that allows each State agency responsible for administering a State plan for medical assistance under title XIX of the Social Security Act access to relevant data on improper or fraudulent payments made under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ) for health care items or services provided to dual eligible individuals. In this section, the term dual eligible individual means an individual who is entitled to, or enrolled for, benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.), or enrolled for benefits under part B of title XVIII of such Act ( 42 U.S.C. 1395j et seq. ), and is eligible for medical assistance under a State plan under title XIX of such Act ( 42 U.S.C. 1396 et seq. ) or under a waiver of such plan.
Connectionstraces to 5
Citation graph
cites case law
Sec. 202
Improving the sharing of data between the Federal Government and State Medicaid programs
Cites 5Cited by 0 across 0 sources