Page:United States Statutes at Large Volume 124.djvu/800

 124 STAT. 774 PUBLIC LAW 111–148—MAR. 23, 2010 (1) STATE PLAN AMENDMENT.—Section 1902(a)(42) of the Social Security Act (42 U.S.C. 1396a(a)(42)) is amended— (A) by striking ‘‘that the records’’ and inserting ‘‘that— ‘‘(A) the records’’; (B) by inserting ‘‘and’’ after the semicolon; and (C) by adding at the end the following: ‘‘(B) not later than December 31, 2010, the State shall— ‘‘(i) establish a program under which the State contracts (consistent with State law and in the same manner as the Secretary enters into contracts with recovery audit contractors under section 1893(h), sub- ject to such exceptions or requirements as the Secretary may require for purposes of this title or a particular State) with 1 or more recovery audit contractors for the purpose of identifying underpayments and overpay- ments and recouping overpayments under the State plan and under any waiver of the State plan with respect to all services for which payment is made to any entity under such plan or waiver; and ‘‘(ii) provide assurances satisfactory to the Sec- retary that— ‘‘(I) under such contracts, payment shall be made to such a contractor only from amounts recovered; ‘‘(II) from such amounts recovered, payment— ‘‘(aa) shall be made on a contingent basis for collecting overpayments; and ‘‘(bb) may be made in such amounts as the State may specify for identifying under- payments; ‘‘(III) the State has an adequate process for entities to appeal any adverse determination made by such contractors; and ‘‘(IV) such program is carried out in accordance with such requirements as the Secretary shall specify, including— ‘‘(aa) for purposes of section 1903(a)(7), that amounts expended by the State to carry out the program shall be considered amounts expended as necessary for the proper and effi- cient administration of the State plan or a waiver of the plan; ‘‘(bb) that section 1903(d) shall apply to amounts recovered under the program; and ‘‘(cc) that the State and any such contrac- tors under contract with the State shall coordi- nate such recovery audit efforts with other contractors or entities performing audits of entities receiving payments under the State plan or waiver in the State, including efforts with Federal and State law enforcement with respect to the Department of Justice, including the Federal Bureau of Investigations, the Inspector General of the Department of Health and Human Services, and the State medicaid fraud control unit; and’’. Deadline.