H.R.2309 - Medicare and Medicaid Fraud Prevention Act (119th Congress)
Summary
H.R.2309, the Medicare and Medicaid Fraud Prevention Act, aims to amend Title XIX of the Social Security Act to enhance provider screening within the Medicaid program. The bill mandates that states check the Death Master File for enrolled providers and suppliers at enrollment/revalidation and quarterly thereafter, starting January 1, 2027. This is intended to prevent fraud by ensuring payments are not made to deceased individuals or entities.
Expected Effects
The primary effect will be increased scrutiny of Medicaid providers to prevent fraudulent claims. States will be required to implement the Death Master File checks, potentially increasing administrative burden. Ultimately, the goal is to reduce improper payments and safeguard taxpayer dollars.
Potential Benefits
- Reduced fraud and improper payments in the Medicaid program.
- Enhanced integrity of the Medicaid system.
- More efficient use of taxpayer funds.
- Prevention of payments to deceased providers or suppliers.
- Improved accountability in healthcare spending.
Most Benefited Areas:
Potential Disadvantages
- Potential increase in administrative costs for states to implement the new screening requirements.
- Possible delays in provider enrollment or revalidation due to the screening process.
- Risk of false positives, requiring additional verification and potentially delaying legitimate payments.
- Limited impact if fraud is perpetrated through other means.
- May not address more sophisticated fraud schemes.
Constitutional Alignment
The bill appears to align with the Constitution, particularly the implied power of Congress to legislate for the general welfare (Article I, Section 8). It falls under Congress's authority to regulate interstate commerce and to make laws necessary and proper for carrying out its enumerated powers. The bill does not appear to infringe on any specific constitutional rights or liberties.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).