Establishes program integrity requirements for high-risk provider types under medical assistance.

This bill establishes program integrity requirements for high-risk provider types under medical assistance. It requires the commissioner to designate provider types as "limited-risk," "moderate-risk," or "high-risk" based on criteria and standards used to designate Medicare providers. For high-risk providers, the commissioner must issue an enrollment moratorium and establish prepayment review of fee-for-service claims. The commissioner must also conduct background studies, revalidate provider enrollment, and require surety bonds for certain providers.

Establishes program integrity requirements for high-risk provider types under medical assistance.

This bill establishes program integrity requirements for high-risk provider types under medical assistance. It requires the commissioner to designate provider types as "limited-risk," "moderate-risk," or "high-risk" based on criteria and standards used to designate Medicare providers. For high-risk providers, the commissioner must issue an enrollment moratorium and establish prepayment review of fee-for-service claims. The commissioner must also conduct background studies, revalidate provider enrollment, and require surety bonds for certain providers.