,,ii  #aac? ,,congress  #a/ ,session    
,s4 #aabc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #aj1 #bjac ,mr4  
,c>p] 7= himself1 ,mr4 ,coburn1 ,mr4    
,b5net1 ,mr4 ,coons1 ,ms4 ,klobu*>1 ,ms4
 ,l&rieu1 ,mrs4 ,mc,caskill1 ,mr4 ,w>n]1
 ,ms4 ,ayotte1 ,mr4 ,enzi1 ,mr4         
,isakson1 & ,mr4 ,cork]7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d titles ,,xviii & ,,xix ( !     
,social ,security ,act to curb wa/e1    
fraud1 & abuse 9 ! ,m$ic>e & ,m$icaid   
programs4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,prev5t+ & ,r$uc+ ,improp]  
,m$ic>e & ,m$icaid ,exp5ditures ,act (  
#bjac or ! ,,prime ,act ( #bjac 4  7b7  
,table ( cont5ts ,! table ( cont5ts (   
?is ,act is z foll[s3  ,sec4 #a4 ,%ort  
title2 table ( cont5ts4 ,,title         
,i--,curb+ improp] paym5ts ,sec4 #aja4  
,requir+ valid prescrib] ,national      
,provid] ,id5tifi]s on ph>macy claims4  
,sec4 #ajb4 ,re=m+ h[ ,,cms tracks &    

corrects ! vuln]abilities id5tifi$ by   
,recov]y ,audit ,contractors4 ,sec4     
#ajc4 ,improv+ ,s5ior ,m$ic>e ,patrol & 
fraud report+ rew>ds4 ,sec4 #ajd4       
,/r5g!n+ ,m$icaid ,program integrity    
?r\gh flexibility4 ,sec4 #aje4 ,e/abli%+
 ,m$ic>e adm9i/rative contractor error  
r$uction inc5tives4 ,sec4 #ajf4 ,/r5g!n+
 p5alties = ! illegal di/ribution ( a   
,m$ic>e1 ,m$icaid1 or ,,*ip b5efici>y   
id5tification or bill+ privileges4      
,,title ,,ii--,improv+ data %>+ ,sec4   
#bja4 ,access to ! ,national ,directory 
( ,new ,hires4 ,sec4 #bjb4 ,improv+ !   
%>+ ( data betwe5 ! ,f$]al ,gov]nm5t &  
,/ate ,m$icaid programs4 ,sec4 #bjc4    
,improv+ claims process+ & detection (  
fraud )9 ! ,m$icaid & ,,*ip programs4   
,,title ,,iii--,report on implem5tation 
,sec4 #cja4 ,report on implem5tation4   
,i ,curb+ improp] paym5ts  #aja4        
,requir+ valid prescrib] ,national      
,provid] ,id5tifi]s on ph>macy claims   
,section #ahfj;,d-#d7;c7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           

#aciew-#ajd7;c77 is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#d7        
,requir+ valid prescrib] ,national      
,provid] ,id5tifi]s on ph>macy claims   
7,a7 ,9 g5]al ,= plan ye> #bjae &       
subsequ5t plan ye>s1 subject to         
subp>agraph 7,b71 ! ,secret>y %all      
prohibit ,,pdp sponsors ( prescription  
drug plans f pay+ claims = prescription 
drugs "u ?is "p t d n include a valid   
prescrib] ,national ,provid] ,id5tifi]4 
7,b7 ,proc$ures ,! ,secret>y %all       
e/abli%--  7i7 proc$ures = det]m9+ !    
validity ( prescrib] ,national ,provid] 
,id5tifi]s "u subp>agraph 7,a72 &  7ii7 
proc$ures = transf]r+ to ! ,inspector   
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices & appropriate law en=cem5t     
ag5cies & o!r ov]sight entities         
in=mation on ^? ,national ,provid]      
,id5tifi]s & ph>macy claims1 includ+    
records relat$ to su* claims1 t !       
,secret>y det]m9es are invalid "u clause
 7i74  7,c7 ,report ,n lat] ?an ,janu>y 
#a1 #bjag1 ! ,inspector ,g5]al ( !      

,dep>tm5t ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report on !  
effectiv5ess ( ! proc$ures e/abli%$ "u  
subp>agraph 7,b74  4  #ajb4 ,re=m+ h[   
,,cms tracks & corrects ! vuln]abilities
 id5tifi$ by ,recov]y ,audit            
,contractors  7a7 ,9 g5]al ,section     
#ahic7;h7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;ddd7h77 is am5d$-- 
7#a7 9 p>agraph 7#h7--  7,a7 by /rik+   
report4--,! ,secret>y & ins]t+          
8report4--  7,a7 ,9 g5]al ,subject to   
subp>agraph 7,c71 ! ,secret>y  2 &  7,b7
 by add+ aft] subp>agraph 7,a71 z ins]t$
 by subp>agraph 7,a71 ! foll[+ new      
subp>agraphs3  7,b7 ,inclusion ( improp]
 paym5t vuln]abilities id5tifi$ ,ea*    
report submitt$ "u subp>agraph 7,a7     
%all1 subject to subp>agraph 7,c71      
include--  7i7 a description (--  7,i7 !
 types & f9ancial co/ to ! program "u   
?is title ( improp] paym5t              
vuln]abilities id5tifi$ by recov]y audit
 contractors "u ?is subsection2 &       
7,,ii7 h[ ! ,secret>y is address+ su*   

improp] paym5t vuln]abilities2 &  7ii7  
an assessm5t ( ! effectiv5ess ( *anges  
made to paym5t policies & proc$ures "u  
?is title 9 ord] to address !           
vuln]abilities s id5tifi$4  7,c7        
,limitation ,! ,secret>y %all ensure t  
ea* report submitt$ "u subp>agraph 7,a7 
does n include in=mation t ! ,secret>y  
det]m9es w\ld be s5sitive or w\ld       
o!rwise negatively impact program       
integrity4  2 &  7#b7 by add+ at ! end !
 foll[+ new p>agraph3  7#aj7 ,address+  
improp] paym5t vuln]abilities ,!        
,secret>y %all address improp] paym5t   
vuln]abilities id5tifi$ by recov]y audit
 contractors "u ?is subsection 9 a      
timely mann]1 prioritiz$ bas$ on ! risk 
to ! program "u ?is title4  4  7b7 ,use 
( ,m$ic>e & ,m$icaid recov]y audit      
contractor recov]ies = provid] education
 & ,to prev5t improp] paym5ts & fraud   
7#a7 ,m$ic>e ,,rac program ,section     
#ahic7;h77#a77;,c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acie;ddd7h77#a77;,c77 is am5d$--  7,a7 

by /rik+ ! ,secret>y %all reta9 & ins]t+
 8! ,secret>y--  7i7 %all reta9  2  7,b7
 9 clause 7i71 z add$ by subp>agraph    
7,a7--  7i7 by ins]t+ 1 9 addition to   
any o!r funds t may be available1 aft]  
available2  7ii7 by ins]t+ until exp5d$ 
aft] ,s]vices2 &  7iii7 by /rik+ ! p]iod
 at ! end & ins]t+ a semicolon2 &  7,c7 
by add+ at ! end ! foll[+ new clauses3  
7ii7 may reta9 an additional portion ( !
 am\nts recov]$ 7n to exce$ #be p]c5t ( 
su* am\nts recov]$7 :i* %all be         
available1 9 addition to any o!r funds t
 may be available1 to su* program       
managem5t acc\nt until exp5d$ = purposes
 ( activities to address problems t     
contribute to improp] paym5ts & fraud "u
 ?is title2 &  7iii7 %all reta9 an      
additional #e p]c5t ( su* am\nts recov]$
 to be made available1 9 addition to any
 o!r funds t may be available1 to !     
,inspector ,g5]al ( ! ,dep>tm5t ( ,heal?
 & ,human ,s]vices until exp5d$ = !     
,inspector ,g5]al to c>ry out activities
 ( ! ,inspector ,g5]al relat+ to        

inve/igat+ improp] paym5ts or audit+    
int]nal controls associat$ ) paym5ts "u 
?is title4  4  7#b7 ,m$icaid ,,rac      
program ,section #aicf ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acifu-#f7
 is am5d$ by add+ at ! end ! foll[+ new 
subsection3  7f7 ,am\nts recov]$ ?r\gh  
recov]y audit contractors ,not)/&+ any  
o!r provision ( law1 ! ,secret>y--  7#a7
 may reta9 a portion ( ! am\nts recov]$ 
pursuant to ! program e/abli%$ "u       
section #aijb7;a77#db77;,b7 7n to exce$ 
#be p]c5t ( ! ,f$]al %>e ( su* am\nts   
recov]$7 :i* %all be available1 9       
addition to any o!r funds t may be      
available1 to ! program managem5t acc\nt
 ( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices
 = purposes ( activities to address     
problems t contribute to improp] paym5ts
 & fraud "u ?is title2 &  7#b7 %all     
reta9 an additional #e p]c5t ( ! ,f$]al 
%>e ( su* am\nts recov]$ to be made     
available1 9 addition to any o!r funds t
 may be available1 to ! ,inspector      
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  

,s]vices until exp5d$ = ! ,inspector    
,g5]al to c>ry out activities ( !       
,inspector ,g5]al relat+ to inve/igat+  
improp] paym5ts or audit+ int]nal       
controls associat$ ) paym5ts "u ?is     
title4  4  7#c7 ,effective date ,!      
am5dm5ts made by ?is section %all take  
effect on ,janu>y #a1 #bjad4  #ajc4     
,improv+ ,s5ior ,m$ic>e ,patrol & fraud 
report+ rew>ds  7a7 ,9 g5]al ,!         
,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7    
%all develop a plan to revise ! inc5tive
 program "u section #bjc7;b7 ( ! ,heal? 
,insurance ,portability & ,acc\ntability
 ,act ( #aiif 7#db ,u4,s4,c4            
#acie;b-#e7;b77 to enc\rage great]      
p>ticipation by individuals to report   
fraud & abuse 9 ! ,m$ic>e program4 ,su* 
plan %all include recomm5dations =--    
7#a7 ways to enhance rew>ds =           
individuals report+ "u ! inc5tive       
program1 includ+ rew>ds bas$ on         
in=mation t leads to an adm9i/rative    
action2 &  7#b7 ext5d+ ! inc5tive       

program to ! ,m$icaid program4  7b7     
,public aw>5ess & education campaign ,! 
plan develop$ "u subsection 7a7 %all    
also include recomm5dations = ! use ( ! 
,s5ior ,m$ic>e ,patrols au?oriz$ "u     
section #daa ( ! ,old] ,am]icans ,act ( 
#aife 7#db ,u4,s4,c4 #cjcb7 to conduct a
 public aw>5ess & education campaign to 
enc\rage p>ticipation 9 ! revis$        
inc5tive program "u subsection 7a74  7c7
 ,submission ( plan ,n lat] ?an #ahj    
days aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y %all submit to ,congress !  
plan develop$ "u subsection 7a74  #ajd4 
,/r5g!n+ ,m$icaid ,program integrity    
?r\gh flexibility ,section #aicf ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acifu-#f7 is am5d$--  7#a7 9 subsection
 7a71 by ins]t+ 1 or o!rwise1 aft]      
entities2 &  7#b7 9 subsection 7e7--    
7,a7 9 p>agraph 7#a71 9 ! matt] prec$+  
subp>agraph 7,a71 by ins]t+ 7includ+ !  
co/s ( equipm5t1 sal>ies & b5efits1 &   
travel & tra9+7 aft] ,program "u ?is    
section2 &  7,b7 9 p>agraph 7#c71 by    

/rik+ by #ajj & ins]t+ by #ajj1 or su*  
numb] z det]m9$ necess>y by ! ,secret>y 
to c>ry out ! ,program14  #aje4         
,e/abli%+ ,m$ic>e adm9i/rative          
contractor error r$uction inc5tives  7a7
 ,9 g5]al ,section #ahgd;,a7b77#a77;,d7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciekk7b77#a77;,d77 is       
am5d$--  7#a7 by /rik+ quality4--,!     
,secret>y & ins]t+ 8quality4--  7i7 ,9  
g5]al ,subject to clauses 7ii7 & 7iii71 
! ,secret>y  2 &  7#b7 by ins]t+ aft]   
clause 7i71 z add$ by p>agraph 7#a71 !  
foll[+ new clauses3  7ii7 ,improp]      
paym5t error rate r$uction inc5tives ,! 
,secret>y %all provide inc5tives =      
m$ic>e adm9i/rative contractors to r$uce
 ! improp] paym5t error rates 9 _!      
jurisdictions4  7iii7 ,inc5tives ,!     
inc5tives provid$ = "u clause 7ii7--    
7,i7 may include a slid+ scale ( bonus  
paym5ts & additional inc5tives to m$ic>e
 adm9i/rative contractors t r$uce !     
improp] paym5t error rates 9 _!         
jurisdictions to c]ta9 b5*m>k levels1 z 

det]m9$ by ! ,secret>y2 &  7,,ii7 %all  
include sub/antial r$uctions 9 aw>d fee 
paym5ts "u aw>d fee contracts1 = any    
m$ic>e adm9i/rative contractor t rea*es 
an upp] end error ?re%old or o!r ?re%old
 z det]m9$ by ! ,secret>y4  4  7b7      
,effective date  7#a7 ,9 g5]al ,!       
am5dm5ts made by subsection 7a7 %all    
apply to contracts ent]$ into or r5ew$  
on or aft] ! date t is #ab mon?s aft] ! 
date ( enactm5t ( ?is ,act4  7#b7       
,contracts ent]$ into or r5ew$ prior to 
effective date ,9 ! case ( contracts 9  
exi/5ce on or aft] ! date ( ! enactm5t (
 ?is ,act & t are n subject to !        
effective date "u p>agraph 7#a71 !      
,secret>y ( ,heal? & ,human ,s]vices    
%all1 :5 appropriate & practicable1 seek
 to apply ! inc5tives provid$ = 9 !     
am5dm5ts made by subsection 7a7 ?r\gh   
contract modifications4  #ajf4 ,/r5g!n+ 
p5alties = ! illegal di/ribution ( a    
,m$ic>e1 ,m$icaid1 or ,,*ip b5efici>y   
id5tification or bill+ privileges       
,section #aabh;,b7b7 ( ! ,social        

,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;b7b77 is am5d$ by add+ at !  
end ! foll[+3  7#d7 ,:oev] kn[+ly1      
int5tionally1 & ) ! int5t to defraud    
pur*ases1 sells or di/ributes1 or       
arranges = ! pur*ase1 sale1 or          
di/ribution ( a ,m$ic>e1 ,m$icaid1 or   
,,*ip b5efici>y id5tification numb] or  
bill+ privileges "u title ,,xviii1 title
 ,,xix1 or title ,,xxi %all be imprison$
 = n m ?an #aj ye>s or f9$ n m ?an      
#ejj1jjj 7#a1jjj1jjj 9 ! case ( a       
corporation71 or bo?4  4  ,,ii ,improv+ 
data %>+  #bja4 ,access to ! ,national  
,directory ( ,new ,hires ,section       
#dec7;j7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #fec 7j77 is am5d$ by add+ at
 ! end ( ! foll[+ new p>agraph3  7#ab7  
,in=mation comp>isons & disclosures to  
assi/ 9 adm9i/ration ( ! ,m$ic>e program
 & ,/ate heal? subsidy programs  7,a7   
,disclosure to ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices ,!        
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid %all h access to ! in=mation 9 

! ,national ,directory ( ,new ,hires =  
purposes ( det]m9+ ! eligibility ( an   
applicant =1 or enrollee 91 ! ,m$ic>e   
program "u title ,,xviii or an          
applicable ,/ate heal? subsidy program  
7z def9$ 9 section #adac7;e7 ( ! ,pati5t
 ,protection & ,af=dable ,c>e ,act 7#db 
,u4,s4,c4 #ahjhc7;e7774  7,b7           
,disclosure to ! ,inspector ,g5]al ( !  
,dep>tm5t ( ,heal? & ,human ,s]vices    
7i7 ,9 g5]al ,if ! ,inspector ,g5]al ( !
 ,dep>tm5t ( ,heal? & ,human ,s]vices   
transmits to ! ,secret>y ! names &      
social security acc\nt numb]s (         
individuals1 ! ,secret>y %all disclose  
to ! ,inspector ,g5]al in=mation on su* 
individuals & _! employ]s ma9ta9$ 9 !   
,national ,directory ( ,new ,hires4     
7ii7 ,use ( in=mation ,! ,inspector     
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices may use in=mation provid$ "u   
clause 7i7 only = purposes (--  7,i7    
det]m9+ ! eligibility ( an applicant =1 
or enrollee 91 ! ,m$ic>e program "u     
title ,,xviii or an applicable ,/ate    

heal? subsidy program 7z def9$ 9 section
 #adac7;e7 ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjhc7;e7772 or  7,,ii7 evaluat+ !     
integrity ( ! ,m$ic>e program or an     
applicable ,/ate heal? subsidy program  
7z s def9$74  7,c7 ,disclosure to ,/ate 
ag5cies  7i7 ,9 g5]al ,if1 = purposes ( 
adm9i/]+ an applicable ,/ate heal?      
subsidy program 7z def9$ 9 section      
#adac7;e7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjhc7;e7771 a ,/ate ag5cy responsible 
= adm9i/]+ su* program transmits to !   
,secret>y ! names & social security     
acc\nt numb]s ( individuals1 ! ,secret>y
 %all disclose to su* ,/ate ag5cy       
in=mation on su* individuals & _!       
employ]s ma9ta9$ 9 ! ,national          
,directory ( ,new ,hires1 subject to ?is
 subp>agraph4  7ii7 ,condition on       
disclosure by ! ,secret>y ,! ,secret>y  
%all make a disclosure "u clause 7i7    
only to ! ext5t t ! ,secret>y det]m9es t
 ! disclosure w\ld n int]f]e ) !        

effective op]ation ( ! program "u ?is   
"p4  7iii7 ,use & disclosure ( in=mation
 by ,/ate ag5cies  7,i7 ,9 g5]al ,a     
,/ate ag5cy may n use or disclose       
in=mation provid$ "u clause 7i7 except =
 purposes ( adm9i/]+ a program ref]r$ to
 9 clause 7i74  7,,ii7 ,in=mation       
security ,! ,/ate ag5cy %all h 9 effect 
data security & control policies t !    
,secret>y f9ds adequate to ensure !     
security ( in=mation obta9$ "u clause   
7i7 & to ensure t access to su*         
in=mation is re/rict$ to au?oriz$ p]sons
 = purposes ( au?oriz$ uses &           
disclosures4  7,,iii7 ,p5alty = misuse (
 in=mation ,an (fic] or employee ( !    
,/ate ag5cy :o fails to comply ) ?is    
clause %all be subject to ! sanctions "u
 subsection 7l77#b7 to ! same ext5t z if
 su* (fic] or employee 7 an (fic] or    
employee ( ! ,unit$ ,/ates4  7iv7       
,proc$ural requirem5ts ,/ate ag5cies    
reque/+ in=mation "u clause 7i7 %all    
adh]e to uni=m proc$ures e/abli%$ by !  
,secret>y gov]n+ in=mation reque/s &    

data mat*+ "u ?is p>agraph4  7v7        
,reimbursem5t ( co/s ,! ,/ate ag5cy %all
 reimburse ! ,secret>y1 9 accordance )  
subsection 7k77#c71 = ! co/s incurr$ by 
! ,secret>y 9 furni%+ ! in=mation       
reque/$ "u ?is subp>agraph4  4  #bjb4   
,improv+ ! %>+ ( data betwe5 ! ,f$]al   
,gov]nm5t & ,/ate ,m$icaid programs  7a7
 ,9 g5]al ,! ,secret>y ( ,heal? & ,human
 ,s]vices 79 ?is section ref]r$ to z !  
,secret>y7 %all e/abli% a plan to       
enc\rage & facilitate ! p>ticipation (  
,/ates 9 ! ,m$ic>e-,m$icaid ,data ,mat* 
,program 7commonly ref]r$ to z !        
,m$i-,m$i ,program7 "u section #ahic7;g7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acie;ddd7g774  7b7 ,program  
revisions ,to improve ,m$i-,m$i ,data   
,mat* ,program p>ticipation by ,/ates   
,section #ahic7;g77#a77;,a7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acie;ddd7g77#a77;,a77 is am5d$--  7#a7 
9 ! matt] prec$+ clause 7i71 by ins]t+  
or o!rwise aft] eligible entities2  7#b7
 9 clause 7i7--  7,a7 by ins]t+ to      

review claims data aft] algori?ms2 &    
7,b7 by /rik+ s]vice1 "t1 or pati5t &   
ins]t+ provid]1 s]vice1 "t1 or pati5t2  
7#c7 9 clause 7ii7--  7,a7 by ins]t+ to 
inve/igate & recov] am\nts ) respect to 
suspect claims aft] appropriate actions2
 &  7,b7 by /rik+ 2 & & ins]t+ a        
semicolon2  7#d7 9 clause 7iii71 by     
/rik+ ! p]iod & ins]t+ 2 &2 &  7#e7 by  
add+ at end ! foll[+ new clause3  7iv7  
fur!r+ ! ,secret>y's design1 developm5t1
 in/allation1 or enhancem5t ( an        
automat$ data sy/em ar*itecture--  7,i7 
to collect1 integrate1 & assess data =  
purposes ( program integrity1 program   
ov]sight1 & adm9i/ration1 includ+ !     
,m$i-,m$i ,program2 &  7,,ii7 t improves
 ! coord9ation ( reque/s = data f       
,/ates4  4  7c7 ,provid+ /ates ) data on
 improp] paym5ts made = items or s]vices
 provid$ to dual eligible individuals   
7#a7 ,9 g5]al ,! ,secret>y %all develop 
& implem5t a plan t all[s ea* ,/ate     
ag5cy responsible = adm9i/]+ a ,/ate    
plan = m$ical assi/ance "u title ,,xix (

 ! ,social ,security ,act access to     
relevant data on improp] or fraudul5t   
paym5ts made "u ! ,m$ic>e program "u    
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 = heal?  
c>e items or s]vices provid$ to dual    
eligible individuals4  7#b7 ,dual       
eligible individual def9$ ,9 ?is        
section1 ! t]m dual eligible individual 
means an individual :o is entitl$ to1 or
 enroll$ =1 b5efits "u "p ,a ( title    
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie;c et seq471 or enroll$ =
 b5efits "u "p ,b ( title ,,xviii ( su* 
,act 7#db ,u4,s4,c4 #acie;j et seq471 & 
is eligible = m$ical assi/ance "u a     
,/ate plan "u title ,,xix ( su* ,act    
7#db ,u4,s4,c4 #acif et seq47 or "u a   
waiv] ( su* plan4  #bjc4 ,improv+ claims
 process+ & detection ( fraud )9 !      
,m$icaid & ,,*ip programs  7a7 ,m$icaid 
,section #aijc7;i7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acif;b7i771 z     
am5d$ by section #bjja7;a77#b77;,b7 ( ! 
,pati5t ,protection & ,af=dable ,c>e    

,act 7,public ,law #aaa-adh71 is am5d$--
  7#a7 9 p>agraph 7#be71 by /rik+ or at 
! end2  7#b7 9 p>agraph 7#bf71 by /rik+ 
! p]iod & ins]t+ 2 or2 &  7#c7 by add+  
aft] p>agraph 7#bf71 ! foll[+ new       
p>agraph3  7#bg7 ) respect to am\nts    
exp5d$ = an item or s]vice = :i* m$ical 
assi/ance is provid$ "u ! ,/ate plan or 
"u a waiv] ( su* plan unless ! claim =  
paym5t = su* item or s]vice conta9s a   
valid b5efici>y id5tification numb] t1 =
 purposes ( ! individual :o receiv$ su* 
item or s]vice1 has be5 det]m9$ by !    
,/ate ag5cy to correspond to an         
individual :o is eligible to receive    
b5efits "u ! ,/ate plan or waiv]4  4    
7b7 ,,*ip ,section #bajg7;e77#a77;,i7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acig;gg7e77#a77;,i77 is am5d$ by /rik+ 
& 7#ag7 & ins]t+ 7#ag71 & 7#bg74  ,,iii 
,report on implem5tation  #cja4 ,report 
on implem5tation ,n lat] ?an #bgj days  
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report on !  

implem5tation ( ! provisions (1 & !     
am5dm5ts made by1 ?is ,act4