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This proposed rule includes provisions that would promote payment accuracy and efficiency and help CMS identify and deter fraud, waste, and abuse in a timely, effective manner, enabling the Agency to protect the Medicare and Medicaid programs and the Children’s Health Insurance Program (CHIP). This rule would implement portions of section 6101(a) of the Patient Protection and Affordable Care Act (Affordable Care Act), which require the disclosure of certain ownership, managerial, and other information regarding Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities.

Statement of Need:

This rule is necessary to strengthen CMS’s program integrity efforts across Medicare, Medicaid, and the CHIP and increase transparency and accountability.

Summary of the Legal Basis:

The proposals included in this rule will address several sections of title XVIII of the Social Security Act.

Alternatives:

Alternatives considered will be described in the rule.

Anticipated Costs and Benefits:

As many of the provisions to be included in this rule are still under development, it is not possible at this time to provide cost and benefit estimates.  As it is developed further, such estimates will be included in the proposed rule.

Risks:

The proposed provisions included in this rule would address a number of program integrity vulnerabilities.  Risks of the proposals are still under development and will be included in the rule.