Sec. 9. IMPROVING THE SHARING OF DATA BETWEEN THE FEDERAL GOVERNMENT AND STATE MEDICAID PROGRAMS
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## SEC. 9 IMPROVING THE SHARING OF DATA BETWEEN THE FEDERAL GOVERNMENT AND STATE MEDICAID PROGRAMS **[**[42 U.S.C. 1395ddd note](/us/usc/t42/s1395ddd)**]** ###
(a)In General 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)). ###
(b)Program Revisions To Improve Medi-Medi Data Match Program Participation by States Section 1893(g)(1)(A) of the Social Security Act (42 U.S.C. 1395ddd(g)(1)(A)) is amended— ####
(1)in the matter preceding clause (i), by inserting “or otherwise” after “eligible entities”; ####
(2)in clause (i)— #####
(A)by inserting “to review claims data” after “algorithms”; and #####
(B)by striking “service, time, or patient” and inserting “provider, service, time, or patient”; ####
(3)in clause (ii)— #####
(A)by inserting “to investigate and recover amounts with respect to suspect claims” after “appropriate actions”; and #####
(B)by striking “; and” and inserting a semicolon; ####
(4)in clause (iii), by striking the period and inserting“ ; and”; and ####
(5)by adding at the end the following new clause: > > ###### “(iv) > > furthering the Secretary’s design, development, installation, or enhancement of an automated data system architecture— > > > ###### “(I) > > to collect, integrate, and assess data for purposes of program integrity, program oversight, and administration, including the Medi-Medi Program; and > > > ###### “(II) > > that improves the coordination of requests for data from States.” > . ###
(c)Providing States With Data on Improper Payments Made for Items or Services Provided to Dual Eligible Individuals **[**[42 U.S.C. 1305ddd note](/us/usc/t42/s1305ddd)**]** ####
(1)In general 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. ####
(2)Dual eligible individual defined 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.
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- 42 USC 1305ddd
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Sec. 9
IMPROVING THE SHARING OF DATA BETWEEN THE FEDERAL GOVERNMENT AND STATE MEDICAID PROGRAMS
Cite42 USC 1305ddd
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