CMS Says it will Subject Some Medicaid Providers to Criminal Background Checks to Prevent Fraud

cmsAccording to a letter sent Tuesday to state Medicaid directors by the U.S. Center for Medicare & Medicaid Services (CMS), all healthcare providers who are considered “high risk” for defrauding state Medicaid programs will have to undergo a criminal background check starting August 1.

States will need to “use their discretion to rank providers,” wrote Virgil Dickson in an article in Modern Healthcare about this announcement, adding that “all of a states’ Medicaid and CHIP providers must be ranked as having a limited, moderate or high risk of defrauding the program” by March 2016.

“Strengthening and improving upon programs that provide vital services like Medicaid to millions of Americans is a continuous process, and at CMS we take seriously our responsibilities to taxpayers and beneficiaries,” said Dr. Shantanu Agrawal, director of CMS’ Center for Program Integrity, said in the Modern Healthcare article.