Here are five things to know:
1. The fragmented databases’ inconsistencies result in some states labeling providers as ineligible while other states deeming the same providers eligible.
2. Some states and Medicaid plans use screening information from 22 various databases, which 15 different federal agencies manage.
3. With the fragmented sources, some states find it challenging to identify ineligible providers.
4. Providers are deemed ineligible for the Medicaid program if they were convicted of Medicaid-related fraud or patient abuse. Also, providers are ineligible if their licenses were suspended.
5. The report suggests CMS offer additional databases for provider screenings and coordinate with all agencies to establish a common ineligibility identifier across databases.
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