(b) REVISION OF PROMPT PAY PROVISIONS.—Sec-
tions 1816(c)(2) and 1842(c)(2) of such Act (42 U.S.C. 
1395h(c)(2), 1395u(c)(2)) are each amended— 
(1) in subparagraph (A), by striking ‘‘Each 
contract’’ and inserting ‘‘Subject to subparagraph 
(C), each contract’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) Subparagraph (A) shall not apply to claims of 
providers or suppliers in cases in which the Secretary iden-
tifies a pattern or practice of claim submission that appear 
to be suspicious or otherwise indicative of a higher likeli-
hood of being fraudulent.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) MEDICAID.—Section 1902(a) of the Social 
Security Act (42 U.S.C. 1396a(a)) is amended— 
(A) in paragraph (23), by inserting before 
the semicolon at the end the following: ‘‘or by 
a person to whom or entity to which a morato-
rium under section 1128G(a)(4) is applied dur-
ing the period of such moratorium’’; 
(B) in paragraph (72); by striking at the 
end ‘‘and’’; 
(C) in paragraph (73), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
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(D) by adding after paragraph (73) the 
following new paragraph: 
‘‘(74) provide that the State will enforce any 
determination made by the Secretary under sub-
section (a) (relating to a significant risk of fraudu-
lent activity with respect to a category of provider 
or supplier described in such subsection through use 
of the appropriate procedures described in such sub-
section) or subsection (b) section 1128G and that 
the State will carry out any activities as required by 
the Secretary for purposes of such subsection (a).’’. 
(2) CHIP.—Section 2102 of such Act (42 
U.S.C. 1397bb) is amended by adding at the end the 
following new subsection: 
‘‘(d) PROGRAM INTEGRITY.—A State child health 
plan shall include a description of the procedures to be 
used by the State— 
‘‘(1) to enforce any determination made by the 
Secretary under subsection (a) (relating to a signifi-
cant risk of fraudulent activity with respect to a cat-
egory of provider or supplier described in such sub-
section through use of the appropriate procedures 
described in such subsection) or subsection (b) sec-
tion 1128G; and 
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‘‘(2) to carry out any activities as required by 
the Secretary for purposes of such subsection.’’. 
(3) MEDICARE.—Section 1866(j) of such Act 
(42 U.S.C. 1395cc(j)) is amended by adding at the 
end the following new paragraph: 
‘‘(3) PROGRAM INTEGRITY.—The provisions of 
subsections (a) and (b) of section 1128G apply to 
enrollments and renewals of enrollments of providers 
of services and suppliers under this title.’’. 
(d) CONSULTATION WITH OIG.—In implementing 
the amendments made by this section and determining 
under paragraph (1) of section 1128G(a) of the Social Se-
curity Act, as inserted by subsection (a), that a provider, 
supplier, or type of service, for an area, is a significant 
risk of fraudulent activity, the Secretary of Health and 
Human Services shall consult with the Inspector General 
of the Department of Health and Human Services in order 
to identify classes of providers and suppliers or types of 
items and services, or such a type of provider, supplier, 
or service for a specific geographic area, as being particu-
larly subject to fraud or abuse under Medicare, Medicaid, 
or the State children’s health insurance program. 
(e) ADDITIONAL FUNDING.—There are authorized to 
be appropriated such sums as may be appropriate to carry 
out this section (and the amendments made by this sec-
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tion). Such sums shall be in addition to any amounts that 
may be available from the Health Care Fraud and Abuse 
Control Account under section 1817(k) of the Social Secu-
rity Act (42 U.S.C. 1395i(k)). 
(f) EFFECTIVE DATE; EXPEDITED IMPLEMENTA-
TION.— 
(1) EFFECTIVE DATE.—The amendments made 
by this section shall take effect upon the date of the 
enactment of this Act and section 1128G(b) of the 
Social Security Act shall apply to providers and sup-
pliers that are first approved for participation on 
and after the date that is 6 months after the date 
of the enactment of this Act. 
(2) EXPEDITED IMPLEMENTATION.—The Sec-
retary of Health and Human Services shall promul-
gate regulations not later than 6 months after the 
date of the enactment of this Act to carry out this 
section, which regulations shall be effective and final 
immediately on an interim basis as of the date of 
publication of the interim final regulation. With re-
spect to such an interim final regulation, the Sec-
retary shall provide for a period of public comments 
on such regulation after the date of publication. The 
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Secretary may change or revise such regulation after 
completion of the period of public comment. 
Æ 
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