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HHS/CMS RIN: 0938-AQ58 Publication ID: Spring 2011 
Title: ●Compliance Program For Providers and Suppliers (CMS-6037-P) 
Abstract: This proposed rule implements several provisions of the Affordable Care Act. Section 6401 requires the Secretary to establish the core elements of a compliance program for Medicare, Medicaid and SCHIP providers and suppliers. The compliance program would now be a condition of enrollment. Section 6402(c) requires the Secretary to establish appropriate administrative remedies for any beneficiary that knowingly participated in fraud. Finally, section 6402(d) requires that the Secretary to establish a process for a provider or supplier to return an overpayment to the program, as well establish a process for CMS and its contractors to receive and apply the overpayment. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Undetermined  Unfunded Mandates: Undetermined 
CFR Citation: Not Yet Determined     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: PL 111-148, 6401 (a)(7), 6402 (c), 6402 (d)   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  11/00/2011    
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: State 
Small Entities Affected: Businesses  Federalism: Undetermined 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
John Spiegel
Director, Division of Policy and Regulatory Development, Medicare Program Integrity Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Program Integrity, MS: AR-18-50, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-1909
Fax:410 786-0604
Email: john.spiegel@cms.hhs.gov