Fed Regist. 2006 Aug 28;71(166):51049-85.
This interim final rule with comment period sets forth the State requirements to provide information to us for purposes of estimating improper payments in Medicaid and SCHIP. The Improper Payments Information Act of 2002 (IPIA) requires heads of Federal agencies to estimate and report to the Congress annually these estimates of improper payments for the programs they oversee, and submit a report on actions the agency is taking to reduce erroneous payments. This interim final rule with comment responds to the public comments on the October 5, 2005 interim final rule and sets forth State requirements for submitting claims and policies to the Federal contractor for purposes of conducting FFS and managed care reviews. This interim final rule also sets forth and invites further comments on the State requirements for conducting eligibility reviews and estimating payment error rates due to errors in eligibility determinations.
本带有意见征求期的暂行最终规则规定了各州为估算医疗补助计划(Medicaid)和儿童健康保险计划(SCHIP)中的不当支付而向我们提供信息的要求。2002年《不当支付信息法》(IPIA)要求联邦机构负责人每年对其监管项目的不当支付进行估算并向国会报告,并提交一份关于该机构为减少错误支付而采取行动的报告。本带有意见征求的暂行最终规则回应了对2005年10月5日暂行最终规则的公众意见,并规定了各州为进行按服务项目付费(FFS)和管理式医疗审查而向联邦承包商提交索赔和政策的要求。本暂行最终规则还规定了各州进行资格审查以及估算因资格判定错误导致的支付错误率的要求,并邀请各方进一步发表意见。