There is hereby established the Medicaid Integrity Program (in this section referred to as the "Program") under which the Secretary shall promote the integrity of the program under this subchapter by entering into contracts in accordance with this section with eligible entities, or otherwise, to carry out the activities described in subsection (b).
Activities described in this subsection are as follows:
An entity is eligible to enter into a contract under the Program to carry out any of the activities described in subsection (b) if the entity satisfies the requirements of paragraphs (2) and (3).
The requirements of this paragraph are the following:
The entity has contracted with the Secretary in accordance with such procedures as the Secretary shall by regulation establish, except that such procedures shall include the following:
The Secretary may enter into such contracts without regard to final rules having been promulgated.
The Secretary shall by regulation provide for the limitation of a contractor's liability for actions taken to carry out a contract under the Program, and such regulation shall, to the extent the Secretary finds appropriate, employ the same or comparable standards and other substantive and procedural provisions as are contained in section 1320c-6 of this title.
With respect to the 5-fiscal year period beginning with fiscal year 2006, and each such 5-fiscal year period that begins thereafter, the Secretary shall establish a comprehensive plan for ensuring the integrity of the program established under this subchapter by combatting fraud, waste, and abuse.
Each 5-fiscal year plan established under paragraph (1) shall be developed by the Secretary in consultation with the Attorney General, the Director of the Federal Bureau of Investigation, the Comptroller General of the United States, the Inspector General of the Department of Health and Human Services, and State officials with responsibility for controlling provider fraud and abuse under State plans under this subchapter.
Out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated to carry out the Medicaid Integrity Program under this section (including the costs of equipment, salaries and benefits, and travel and training), without further appropriation-
Amounts appropriated pursuant to paragraph (1) shall remain available until expended.
The Secretary may use amounts appropriated pursuant to paragraph (1) to pay for transportation and the travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of chapter 57 of title 5 while away from their homes or regular places of business, of individuals described in subsection (b)(4) who attend education, training, or consultative activities conducted under the authority of that subsection.
The Secretary shall make available on a website of the Centers for Medicare & Medicaid Services that is accessible to the public-
From the amounts appropriated under paragraph (1), the Secretary shall increase by 100, or such number as determined necessary by the Secretary to carry out the Program, the number of full-time equivalent employees whose duties consist solely of protecting the integrity of the Medicaid program established under this section by providing effective support and assistance to States to combat provider fraud and abuse.
The Secretary shall conduct evaluations of eligible entities which the Secretary contracts with under the Program not less frequently than every 3 years.
Not later than 180 days after the end of each fiscal year (beginning with fiscal year 2006), the Secretary shall submit a report to Congress which identifies-
42 U.S.C. § 1396u-6
EDITORIAL NOTES
REFERENCES IN TEXTSection 202(b) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (c)(3)(B)(ii), is section 202(b) of title II of Pub. L. 104-191, 110 Stat. 1998, which amended sections 1395h and 1395u of this title.
PRIOR PROVISIONSA prior section 1936 of act Aug. 14, 1935, was renumbered section 1939 and is classified to section 1396v of this title.
AMENDMENTS2015-Subsec. (a). Pub. L. 114-115, §6(1), inserted ",or otherwise," after "entities".Subsec. (e)(1). Pub. L. 114-115, §6(2)(A), inserted "(including the costs of equipment, salaries and benefits, and travel and training)" after "Program under this section" in introductory provisions.Subsec. (e)(3). Pub. L. 114-115, §6(2)(B), substituted "by 100, or such number as determined necessary by the Secretary to carry out the Program," for "by 100". 2010-Subsec. (c)(2)(D), (E). Pub. L. 111-148, §6402(j)(2)(A), added subpar. (D) and redesignated former subpar. (D) as (E).Subsec. (e)(1)(C). Pub. L. 111-152, §1303(b)(2)(A), substituted "for each of fiscal years 2009 and 2010" for "for each fiscal year thereafter".Subsec. (e)(1)(D). Pub. L. 111-152, §1303(b)(1), (2) (B), (3), added subpar. (D).Subsec. (e)(4), (5). Pub. L. 111-148, §6402(j)(2)(B), added par. (4) and redesignated former par. (4) as (5). 2008-Subsec. (b)(4). Pub. L. 110-379, §5(a)(1)(A), substituted "Education or training, including at such national, State, or regional conferences as the Secretary may establish, of State or local officers, employees, or independent contractors responsible for the administration or the supervision of the administration of the State plan under this subchapter," for "Education of".Subsec. (e)(2). Pub. L. 110-379, §5(a)(1)(B), added par. (2) and struck out former par. (2). Prior to amendment, text read as follows: "Amounts appropriated pursuant to paragraph (1) shall remain available until expended."Subsec. (e)(2)(B)(ii). Pub. L. 110-379, §5(b)(1), added cl. (ii).
STATUTORY NOTES AND RELATED SUBSIDIARIES
EFFECTIVE DATE OF 2008 AMENDMENT Pub. L. 110-379, §5(a)(2), Oct. 8, 2008, 122 Stat. 4078, provided that: "The amendments made by paragraph (1) [amending this section] shall take effect as if included in the enactment of section 1936 of the Social Security Act [42 U.S.C. 1396u-6], as added by section 6034(a) of the Deficit Reduction Act of 2005 (Public Law 109-171)." Pub. L. 110-379, §5(b)(2), Oct. 8, 2008, 122 Stat. 4079, provided that: "The amendment made by paragraph (1) [amending this section] shall apply to conferences conducted under the authority of section 1936(b)(4) of the Social Security Act (42 U.S.C. 1396u-6(b)(4)) after the date of enactment of this Act [Oct. 8, 2008]."
- Secretary
- The term "Secretary" means the Secretary of Housing and Urban Development.1See References in Text note below.
- United States
- The term "United States" means (but only for purposes of subparagraphs (A) and (B) of this paragraph) the fifty States and the District of Columbia.