DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services
 
CMCS Informational Bulletin 
 
  
DATE:  May 25, 2012 
 
FROM:  Cindy Mann, Director 
  Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:  New Federal Register Publications   
 
This bulletin provides information on three important Federal Register publications: 
  CMS Provider Screening Innovator Challenge (CMS-2382-N) 
  Final Rule Regarding Disallowance of Claims for Federal Financial Participation and 
Technical Corrections (CMS 2292-F) 
  Final Rule to Align Certain Provider Qualifications Between Medicaid and Medicare 
(CMS-9070-F) 
 
Additionally, CMCS published a new set of Questions and Answers regarding Affordable Care 
Act implementation. 
 
CMS Provider Screening Innovator Challenge (CMS-2382-N) 
 
Today the Centers for Medicare & Medicaid Services (CMS) is announcing the launch of the 
CMS Provider Screening Innovator Challenge.  This Challenge is sponsored by CMS and is 
presented as part of the Partnership for Program Integrity Innovation program. It will be 
administered by the National Aeronautic and Space Administrations (NASA) Federal Center of 
Excellence for Collaborative Innovation.  This Challenge supports our goal of improving our 
ability to streamline operations, screen providers, and reduce fraud and abuse.  
 
Specifically, the Challenge is an innovation competition to develop a multi-State, multi-program 
provider screening software application capable of risk scoring, credentialing validation, identity 
authentication, and sanction checks, while also lowering burden on providers and reducing 
administrative and infrastructure expenses for States and Federal programs.  
 
The notice announcing the Challenge is on display at the Federal Register today and may be 
accessed at https://s3.amazonaws.com/public-inspection.federalregister.gov/2012-12633.pdf  
 
Further information about the CMS Provider Screening Innovator Challenge is available at 
http://www.medicaid.gov/State-Resource-Center/Events-and-Announcements/Events-and-
Announcements.html  CMCS Informational Bulletin, Page 2 
Final Rule Regarding Disallowance of Claims for Federal Financial 
Participation and Technical Corrections (CMS 2292-F) 
 
Today CMS is releasing a final rule to implement a provision of the Affordable Care Act and 
other program improvements regarding overpayments to providers and disallowances to States in 
the Medicaid program. In light of State fiscal pressures, the rule also makes additional changes to 
the disallowance repayment process to increase State flexibility. 
 
The final rule implements section 6506 of the Affordable Care Act by increasing the period of 
time States have to collect provider overpayments before they are required to return the Federal 
funds.  Under the new provisions, States will have up to one year from the date of discovery of 
an overpayment made to a Medicaid provider to recover or attempt to recover the overpayment 
before the Federal funds must be returned.  Additionally, the final rule revises the repayment of 
Federal funds by installment by providing three options for States qualifying for and electing a 
repayment schedule.  The options and accompanying repayment schedules recognize the unique 
fiscal pressures States are experiencing.  The final rule also makes several additional changes 
through existing statutory authorities to improve the disallowance process, implement other 
changes to Federal law, and better align policies and practices with the general principles of the 
Presidents Executive Order Improving Regulation and Regulatory Review released on January 
18, 2011. 
  
The final rule is on display in the Federal Register today and can be viewed here 
http://www.ofr.gov/(X(1)S(e3g5ts4wpjscf4puy043hkza))/OFRUpload/OFRData/2012-
12637_PI.pdf.  
 
 
Final Rule to Align Certain Provider Qualifications Between Medicaid and 
Medicare (CMS-9070-F) 
 
On May 16, 2012, CMS published a final rule titled Medicare and Medicaid Programs: 
Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction.  
Among the provisions of this rule is the alignment of Medicaid provider qualifications for 
Physical Therapists and Occupational Therapists with Medicare qualifications.  42 CFR 440.110 
(a) and (b) have been amended to refer to Medicare provider qualifications, ensuring future 
revisions to the Medicare program will be adopted in Medicaid.  This revision can benefit the 
Medicaid program by recognizing individuals qualified to furnish therapy services in the 
Medicare program and facilitating continuity of care for individuals dually eligible for Medicare 
and Medicaid. 
  
The final rule may be accessed at: http://www.gpo.gov/fdsys/pkg/FR-2012-05-16/pdf/2012-
11543.pdf  
 
  CMCS Informational Bulletin, Page 3 
Affordable Care Act Implementation Questions and Answers 
 
This week CMCS published a set of Q&A documents covering some of the most frequently 
asked questions we have received from States regarding Affordable Care Act and Medicaid 
expansion and simplification.  We hope this information will be useful to States and other 
stakeholders and we will make more Q&A available as we develop them.  Topics covered 
include: 
  Eligibility and Enrollment Systems 
  Eligibility Policy 
  Coordination Across Insurance Affordability Programs 
  Section 1115 Waiver Transitions 
  Childrens Health Insurance Program 
  Benefits/Delivery System 
  Federal Medical Assistance Percentages 
 
The Q&A documents are available at: http://www.medicaid.gov/State-Resource-
Center/Frequently-Asked-Questions/CMCS-Ask-Questions.html