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States' Compliance with New Requirements to Prevent Medicaid Payments to Terminated Providers

To prevent terminated providers from treating Medicaid enrollees or receiving Medicaid payments, the 21st Century Cures Act (Cures Act) requires CMS to provide information to all States on Medicaid providers that have been terminated for cause. This study, mandated by the Cures Act, will examine the extent to which terminated providers included in CMS's terminations database have been terminated from all State Medicaid programs and the amount of Medicaid payments for items/services associated with terminated providers. Additionally, this study will examine the extent to which State contracts with managed care entities include a provision that terminated providers are excluded from all managed care networks.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
January 2019 Centers for Medicare & Medicaid Services States' Compliance with New Requirements to Prevent Medicaid Payments to Terminated Providers/td> Office of Evaluation and Inspections OEI-03-19-00070 2020