STATE MEDICAID FRAUD CONTROL

SEC. 13625. STATE MEDICAID FRAUD CONTROL (a) In General.— Section 1902(a) (42 U.S.C. 1396a(a)), as amended by section 13623(a), is amended— (1) by striking “and” at the end of paragraph (59); (2) by striking the period at the end of paragraph (60) and inserting “; and”; and (3) by inserting after paragraph (60) the following new paragraph: “(61) provide that the State must demonstrate that it operates a medicaid fraud and abuse control unit described in section 1903(q) that effectively carries out the functions and requirements described in such section, as determined in accordance with standards established by the Secretary, unless the State demonstrates to the satisfaction of the Secretary that the effective operation of such a unit in the State would not be cost-effective because minimal fraud exists in connection with the provision of covered services to eligible individuals under the State plan, and that beneficiaries under the plan will be protected from abuse and neglect in connection with the provision of medical assistance under the plan without the existence of such a unit.”. (b) Effective Date.— Section 1902(a)(61) of the Social Security Act (as added by subsection (a)) shall take effect January 1, 1995, and the standards referred to in such section shall be established not later than March 31, 1994.