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Series: Audit of Medicaid Unenrolled Providers

Announced on  | Last Modified on  | Series Number: SRS-A-26-023

OBJECTIVE

To strengthen Medicaid provider enrollment, the 21st Century Cures Act (Cures Act) required that all providers that serve Medicaid beneficiaries enroll with their State Medicaid agency effective January 1, 2017, for Medicaid FFS and January 1, 2018, for Medicaid managed care organizations (MCOs). In addition, the Cures Act required that no Federal financial participation be paid for managed care expenditures when States have not complied with the requirement to enroll MCO network providers. States must also return to CMS the Federal share of overpayments associated with unenrolled fee-for-service (FFS) providers. We will determine whether the State agencies complied with these Federal requirements and prohibited payments associated with providers that were not enrolled in their Medicaid FFS and managed care programs.

There is 1 project in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (1)

TIMELINE

  • January 15, 2026
    Series Number SRS-A-26-023 Assigned
  • January 15, 2026
    Project Announced

    Project OAS-25-07-097

  • Today
    1 Project In-Progress
  • Est FY2028
    Estimated Fiscal Year for Series Completion

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