Page:United States Statutes at Large Volume 124.djvu/802

 124 STAT. 776 PUBLIC LAW 111–148—MAR. 23, 2010 Subtitle F—Additional Medicaid Program Integrity Provisions SEC. 6501. TERMINATION OF PROVIDER PARTICIPATION UNDER MED - ICAID IF TERMINATED UNDER MEDICARE OR OTHER STATE PLAN. Section 1902(a)(39) of the Social Security Act (42 U.S.C. 42 U.S.C. 1396a(a)) is amended by inserting after ‘‘1128A,’’ the fol- lowing: ‘‘terminate the participation of any individual or entity in such program if (subject to such exceptions as are permitted with respect to exclusion under sections 1128(c)(3)(B) and 1128(d)(3)(B)) participation of such individual or entity is termi- nated under title XVIII or any other State plan under this title,’’. SEC. 6502. MEDICAID EXCLUSION FROM PARTICIPATION RELATING TO CERTAIN OWNERSHIP, CONTROL, AND MANAGEMENT AFFILIATIONS. Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by section 6401(b), is amended by inserting after para- graph (77) the following: ‘‘(78) provide that the State agency described in paragraph (9) exclude, with respect to a period, any individual or entity from participation in the program under the State plan if such individual or entity owns, controls, or manages an entity that (or if such entity is owned, controlled, or managed by an individual or entity that)— ‘‘(A) has unpaid overpayments (as defined by the Sec- retary) under this title during such period determined by the Secretary or the State agency to be delinquent; ‘‘(B) is suspended or excluded from participation under or whose participation is terminated under this title during such period; or ‘‘(C) is affiliated with an individual or entity that has been suspended or excluded from participation under this title or whose participation is terminated under this title during such period;’’. SEC. 6503. BILLING AGENTS, CLEARINGHOUSES, OR OTHER ALTER- NATE PAYEES REQUIRED TO REGISTER UNDER MED- ICAID. (a) IN GENERAL.—Section 1902(a) of the Social Security Act (42 U.S.C. 42 U.S.C. 1396a(a)), as amended by section 6502(a), is amended by inserting after paragraph (78), the following: ‘‘(79) provide that any agent, clearinghouse, or other alter- nate payee (as defined by the Secretary) that submits claims on behalf of a health care provider must register with the State and the Secretary in a form and manner specified by the Secretary;’’. SEC. 6504. REQUIREMENT TO REPORT EXPANDED SET OF DATA ELE- MENTS UNDER MMIS TO DETECT FRAUD AND ABUSE. (a) IN GENERAL.—Section 1903(r)(1)(F) of the Social Security Act (42 U.S.C. 1396b(r)(1)(F)) is amended by inserting after ‘‘nec- essary’’ the following: ‘‘and including, for data submitted to the Secretary on or after January 1, 2010, data elements from the Determination.