Fed Regist. 1980 Dec 19;45(246):83772-7.
The proposed regulation would require State Medicaid agencies to suspend from program reimbursement all practitioners who are convicted of offenses related to their participation in the Medicaid program and to exclude the Medicaid program reimbursement providers who otherwise defraud or abuse the Medicaid program. The proposed regulation also revises State Medicaid requirements with respect ot the detection and investigation of Medicaid fraud and abuse. This revisions would further clarify State Medicaid agency responsibilities for the control of Medicaid fraud and abuse and strengthen the regulatory requirements so that States can adequately meet their responsibilities. The intent of this proposed regulation is to prevent or discourage those practices which increases the cost of the Medicaid program without benefiting Medicaid recipients.
拟议的法规将要求各州医疗补助机构暂停向所有因参与医疗补助计划而被定罪的从业者支付计划报销费用，并排除那些以其他方式欺诈或滥用医疗补助计划的医疗补助计划报销提供者。拟议的法规还修订了各州医疗补助计划关于医疗补助欺诈和滥用行为的检测和调查要求。此次修订将进一步明确各州医疗补助机构在控制医疗补助欺诈和滥用行为方面的责任，并加强监管要求，以便各州能够充分履行其职责。拟议法规的目的是防止或阻止那些增加医疗补助计划成本却未使医疗补助受益人的行为。
