Medicaid Provider Screening Accountability Act

This bill makes state Medicaid programs check, on a regular basis, whether any health care provider trying to join or stay in Medicaid has been kicked out of Medicare, another state’s Medicaid, or the Children’s Health Insurance Program (CHIP). States must do this when providers enroll or renew, and then keep checking at least monthly using federal and state databases, such as the Data Exchange system. The goal is to block bad actors from moving between programs and protect patients and taxpayers.

These checks start January 1, 2028, and apply to both new enrollments and ongoing participation.

• Who is affected: State Medicaid agencies and all Medicaid providers and suppliers.
• What changes: States must verify at enrollment and then monthly if providers were terminated by Medicare, other states’ Medicaid programs, or CHIP, using designated databases.
• When: The monthly checks begin January 1, 2028.