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Stipulates that states must terminate the participation of any individual or entity (subject to some permissible exclusions) under Medicaid and CHIP if the participation of such individual or entity is terminated under Medicare or other state plan.
Prior to January 2013, CMS issued a final rule in early 2011 in which it addressed implementation guidance for this provision. CMS released an informational bulletin in conjunction with the 2011 final rule. In the spring of 2012, CMS announced the launch of the “CMS Provider Screening Innovator
Challenge,” which called upon qualifying applicants to demonstrate abilities in implementing this section of the ACA, among others.
SEC. 6501. TERMINATION OF PROVIDER PARTICIPATION UNDER MEDICAID IF TERMINATED UNDER MEDICARE OR OTHER STATE PLAN. Section 1902(a)(39) of the Social Security Act (42 U.S.C. 42 U.S.C. 1396a(a)) is amended by inserting after ‘‘1128A,’’ the following: ‘‘terminate the participation of any individual or entity in such program if (subject to such exceptions as are permitted with respect to exclusion under sections 1128(c)(3)(B) and 1128(d)(3)(B)) participation of such individual or entity is terminated under title XVIII or any other State plan under this title,’’.
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