CMS: States Must Screen High-Risk Medicaid Providers

According to new guidance from CMS, states have until the end of July to begin screening high-risk Medicaid and Children's Health Insurance Program (CHIP) providers.

These screenings would involve fingerprint-based criminal background checks and would occur after a state Medicaid agency has been deemed high risk, or susceptible to improper payments. Providers considered high risk by Medicare are also be considered high risk by state Medicaid agencies. Background checks must be completed by June 1, 2016.

Those who would be required to undergo background checks include the high-risk provider as well as anyone with a 5 percent or more direct or indirect ownership interest in the provider.

To read the guidance, click here.