On September 17, 2010,  the Centers for Medicare & Medicaid Services released a proposed rule that would implement provisions of the Affordable Care Act (ACA) that strengthen provider and supplier screening provisions under the Medicare, Medicaid, and Children’s Health Insurance Program (CHIP).  The rule is designed to ensure that “that only legitimate providers and suppliers are enrolled in Medicare, Medicaid, and CHIP, and that only legitimate claims will be paid.” Based on the level of risk associated with different provider and supplier types, CMS would apply three levels of screening tools: (1) “limited risk” providers will have enrollment requirements, license and database verifications; (2) moderate risk will have those verifications plus unscheduled site visits; and (3) high risk will have verifications, unscheduled site visits, criminal background check and fingerprinting. Among many other things, the rule also: authorizes CMS and the states to impose moratoria on the enrollment of new providers when deemed necessary to protect against a high risk of fraud; authorizes the suspension of payments pending an investigation of a credible allegation of fraud; and solicits comments on compliance program requirements included in the ACA. CMS characterizes the rule as being "of critical importance in the transition of CMS’ antifraud activities from "pay and chase" to fraud prevention."  Comments on the proposed rule will be accepted until November 16, 2010. The official version of the rule will be published on September 23, 2010. Reed Smith is reviewing the new proposal and will provide additional analysis in the future.