Summary
Requires that any agent, clearinghouse, or other alternate payee that submits Medicaid claims on behalf of a health care provider register with the state and the Secretary of HHS in a form and manner specified by the Secretary.
Implementation Status
Prior to January 2013, CMS had yet to implement guidance pursuant to this provision, though responded to comments to this effect in a 2011 final rule, noting that the agency would address this provision “in the future.” A September 23, 2011 CMS transmittal, however, does address the incorporation of this provision (and others) into the Medicaid Program Integrity Manual.
Statutory Text
SEC. 6503. BILLING AGENTS, CLEARINGHOUSES, OR OTHER ALTERNATE PAYEES REQUIRED TO REGISTER UNDER MEDICAID. (a) IN GENERAL.—Section 1902(a) of the Social Security Act (42 U.S.C. 42 U.S.C. 1396a(a)), as amended by section 6502(a), is amended by inserting after paragraph (78), the following: ‘‘(79) provide that any agent, clearinghouse, or other alternate payee (as defined by the Secretary) that submits claims on behalf of a health care provider must register with the State and the Secretary in a form and manner specified by the Secretary;’’.