OIG: Terminated Medicaid Providers Continue To Participate Across State Lines

Posted on Thursday, August 6, 2015 9:20 AM

According to a report from the Office of Inspector General, about 12% of providers terminated from one state Medicaid program continued to participate in other states’ Medicaid programs. However, since the implementation of the Affordable Care Act (ACA), every state must terminate a provider’s participation in a Medicaid program if that provider was terminated from another program for reasons of fraud. Regardless of this requirement, the OIG found that 295 of 2,539 providers terminated for cause in 2011 continued to participate in another state’s Medicaid program through January 2014. The OIG recommends that CMS work with state Medicaid agencies to develop uniform terminology to denote cause for terminations. Click here to read more.  

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