Congressman Langworthy Introduces Medicaid Provider Screening Accountability Act

Washington, D.C. — March 6 - OnWednesday, Congressman Nick Langworthy (NY-23) along with co-lead Congressman Joe Morelle (NY-25) introduced the Medicaid Provider Screening Accountability Act, which would require states to regularly check the Data Exchange System (DEX) to determine, as part of a provider’s enrollment in the Medicaid program, that the provider is not prohibited from participating in another state’s Medicaid program. 

This ensures states can identify and prevent providers who have been terminated in other states from re-enrolling from continuing to practice in their Medicaid programs. For example, if a doctor is terminated from Ohio's Medicaid program for committing fraud or harming patients, their information is entered into DEX. Without regular checks, another state—like New York—might unknowingly allow that doctor to participate in its Medicaid program.

The Medicaid Provider Screening Accountability Act is important to help keep bad actors out of the Medicaid system, protecting both the program and the patients who rely on it. For the Medicaid program, this bill helps prevent fraud and misuse of taxpayer dollars by making sure that providers who have been kicked out of another state’s Medicaid program can’t just sign up in a new state and keep practicing. 

“Preventing fraud and misuse of taxpayer dollars while simultaneously protecting Medicaid beneficiaries from dangerous or unethical providers is my top priority,” said Congressman Langworthyin a statement on Wednesday. “This bill strengthens oversight, keeps bad providers out, and ensures Medicaid patients get care from qualified, trustworthy professionals.” 

"The Medicaid program provides life-saving health coverage to millions of Americans, and it's critical we do everything possible to keep the system operating efficiently and with accountability," said Congressman Joe Morelle. "This common-sense legislation would help ensure families are getting the highest-quality coverage possible, all while helping to eliminate fraud and ensure higher levels of accountability within. state Medicaid systems. I'm proud to join Rep. Langworthy in supporting this bipartisan legislation, and I look forward to its swift passage into law." 

Congresswoman Nicole Malliotakis (NY-11) is an original cosponsor of this legislation.

Supporting organizations includeNational Rural Health Association (NRHA), Greater New York Hospital Association (GNYHA), Healthcare Association of New York State (HANYS), and New York State Association of Counties, and Community Health Care Association of New York State.

“The National Rural Health Association (NRHA) thanks Representative Langworthy and Representative Morelle for their work on the Medicaid Provider Screening Accountability Act. This legislation is important for rural populations as about 20% of rural adults and 40% of rural children are covered by Medicaid. It is key that they receive the best care possible from trusted providers,”said Alan Morgan, CEO, NRHA.

New York State Association of Counties Executive Director Stephen Acquario said, “New York’s 62 counties contribute more to Medicaid program than all other counties in the United States combined. With so much at stake for New York's local taxpayers, we’re proud to support this bipartisan legislation that will help ensure that healthcare providers with a history of fraud and patient harm in one state can't simply relocate to a new state to resume victimizing patients and burdening local taxpayers."

"The Healthcare Association of New York State is pleased to support the bipartisan Medicaid Provider Screening Accountability Act as a critical step toward enhancing program integrity and patient safety across our healthcare system,” said HANYS President Bea Grause, RN, JD. "HANYS is committed to ensuring access for our patients and protecting patients from potentially problematic providers is key to that effort.  We believe the commonsense measures in this bill will strengthen the Medicaid program while ensuring that only qualified, reputable providers are delivering care to New Yorkers. HANYS applauds Reps. Nick Langworthy and Joe Morelle for their bipartisan efforts."

###