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Broad program-integrity amendment advances amid debate over nursing-home cuts and oversight
Summary
A sweeping amendment (A13) consolidating provider-enrollment recodification, sanctions, billing-error definitions and program-integrity tools was debated at length; the committee adopted select lines (including clarifying that billing errors are not automatically fraud) but members sharply contested nursing-home rate and prepayment provisions and a proposed termination-for-fraud amendment failed.
Lawmakers spent much of the joint hearing on a large amendment package (A13) that bundles changes to provider enrollment, sanctions and program-integrity rules. Sponsors said A13 compiles proposals from multiple lawmakers and stakeholders; counsel summarized extensive recodification and new policy elements.
Mister Monahan, counsel, walked members through the amendment's main components, saying the first half recodifies provider enrollment statutes and expands verification, fingerprinting, site-visit and revalidation…
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