PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the House Committee on Energy and Commerce.
Congressional Research Service
Version 00 · Introduced in House · Mar 5, 2025
Medicaid Provider Screening Accountability Act
This bill requires state Medicaid programs to check, as part of the provider enrollment and reenrollment process, whether providers were terminated from participating in the Medicare program, any other state Medicaid program, or the Children's Health Insurance Program (CHIP) using certain databases (e.g., the Data EXchange system). The bill requires states to continue to check these databases on at least a monthly basis after providers are enrolled.
People & committees
Rep. Langworthy, Nicholas A. [R-NY-23] · R–NY
Legislative record
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Referred to the House Committee on Energy and Commerce.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: May 30, 2025. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-03-05 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This bill would require states to check whether providers and suppliers enrolling in Medicaid have had their participation terminated in other health programs specified in the bill. Starting January 1, 2028, states would have to conduct these checks at enrollment, reenrollment, and revalidation of enrollment, and at least monthly while providers and suppliers remain enrolled. These are proposed requirements; the supplied evidence does not establish enactment.
Beginning January 1, 2028, as part of the enrollment (or reenrollment or revalidation of enrollment) of a provider or supplier under this title, and not less frequently than monthly during the period that such provider or supplier is so enrolled, the State conducts a check
to determine whether the Secretary has terminated the participation of such provider or supplier under title XVIII, or whether any other State has terminated the participation of such provider or supplier under such other State’s State plan under this title (or waiver of the plan), or such other State’s State child health plan under title XXI (or waiver of the plan).
Section 1 would name the legislation the Medicaid Provider Screening Accountability Act.
This Act may be cited as the Medicaid Provider Screening Accountability Act.
Section 2 would amend section 1902(kk)(1) of the Social Security Act by labeling the existing text as subparagraph (A), “In general,” and adding subparagraph (B), “Additional provider screening.” The added provision would require state checks beginning January 1, 2028, at enrollment, reenrollment, and revalidation of enrollment, and at least monthly throughout enrollment.
Section 1902(kk)(1) of the Social Security Act (42 U.S.C. 1396a(kk)(1)) is amended— (1) by striking The State and inserting: (A) In general The State ; and (2) by adding at the end the following new subparagraph: (B) Additional provider screening
Beginning January 1, 2028, as part of the enrollment (or reenrollment or revalidation of enrollment) of a provider or supplier under this title, and not less frequently than monthly during the period that such provider or supplier is so enrolled, the State conducts a check
States would check any database or similar system developed under section 6401(b)(2) of the Patient Protection and Affordable Care Act. The checks would look for participation terminated by the Secretary under title XVIII, or by another state under its Medicaid plan or state child health plan under title XXI. The other-state checks would also cover the specified plans operating under waivers.
the State conducts a check of any database or similar system developed pursuant to section 6401(b)(2) of the Patient Protection and Affordable Care Act to determine whether the Secretary has terminated the participation of such provider or supplier under title XVIII, or whether any other State has terminated the participation of such provider or supplier under such other State’s State plan under this title (or waiver of the plan), or such other State’s State child health plan under title XXI (or waiver of the plan).
The supplied action snapshot, updated May 30, 2025, records introduction in the House and referral to the House Committee on Energy and Commerce on March 5, 2025.
Source snapshot updated 2025-05-30T23:51:55Z. 2025-03-05: Referred to the House Committee on Energy and Commerce. 2025-03-05: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-03-05. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No provision meeting the rider definition was identified after reviewing the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials, or establish any amendment attachment history.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified after reviewing the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption, preferential treatment, or exception warranting a targeted-benefit finding was identified after reviewing the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: May 30, 2025. How PlainBill uses AI