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HHS/CMS RIN: 0938-AU90 Publication ID: Fall 2022 
Title: Medicare and Medicaid Program Integrity (CMS-6084) 

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.

Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: Undetermined 
CFR Citation: 42 CFR 400    42 CFR 402    42 CFR 405    42 CFR 406    ...     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: 42 U.S.C. 1302    42 U.S.C. 1395hh   
Legal Deadline:  None

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 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.


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.

Action Date FR Cite
NPRM  01/00/2023 
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: Federal, State 
Federalism: Undetermined 
Included in the Regulatory Plan: Yes 
RIN Data Printed in the FR: No 
Agency Contact:
John Spiegel
Senior Advisor
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Program Integrity, MS: AR-19-15, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-1909