Bill Summary for S 496 (2011-2012)

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Summary date: 

Mar 31 2011

Bill Information:

View NCGA Bill Details2011-2012 Session
Senate Bill 496 (Public) Filed Thursday, March 31, 2011
TO PROVIDE FRAUD AND ABUSE PROVISIONS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT.
Intro. by Pate.

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Bill summary

Adds a new GS Chapter 108C, Medicaid and Health Choice Provider Requirements. Requires the Department of Health and Human Services (department) to conduct screening of Medicaid and Health Choice providers and applicants in accordance with the federal Affordable Care Act, related regulations, and the act. Designates types of providers as being in Limited, Moderate, or High Risk Provider Categories, and sets out screening requirements for Limited, Moderate, and High Screening Levels. If a provider could fit in more than one category, the highest must be used. If the provider is also enrolled in Medicare, the department may rely on screening performed by Medicare contractors, and for out-of-state providers, may rely on screening performed by comparable agencies of other states. Enrollment must be revalidated at least every five years. Enrolled providers must permit unannounced on-site inspections of all provider locations. Sets out criminal history record check requirements for certain providers. Authorizes the Division of Medical Assistance, in consultation with stakeholder groups and the state Department of Justice, to study the status of criminal history record and employment background checks among all providers and health care licensing boards and make recommendations to the General Assembly when it reconvenes in 2012 concerning the use of background checks in connection with participation in the Medicaid and Health Choice programs.