CMS recently released a proposed rule to implement the new PPACA provider screening and enforcement measures for Medicare, Medicaid and Children's Health Insurance Program (CHIP). Under the proposed rule, CMS would apply three levels of screening tools: (1) "limited risk" providers, including physicians, nonphysician practitioners, medical clinics and publicly-traded providers/suppliers, will have enrollment requirements, license and database verifications; (2) "moderate risk" providers/suppliers, including comprehensive outpatient rehabilitation facilities (CORFs), independent diagnostic testing facilities (IDTFs) and currently-enrolled durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) suppliers and home health agencies (with the exception of publicly-traded companies), will have the above verifications plus unscheduled site visits; and (3) "high risk" providers/suppliers, including prospective DMEPOS suppliers and home health agencies, will have verifications, unscheduled site visits, criminal background checks and fingerprinting. Additionally, the proposed rule (1) establishes requirements for suspending payments to providers and suppliers based on credible allegations of fraud in Medicare and Medicaid; (2) establishes the authority for imposing a temporary moratorium on Medicare, Medicaid and CHIP enrollment on providers and suppliers when necessary "to help prevent or fight fraud, waste, and abuse without impeding beneficiaries' access to care"; and (3) offers the states guidance on terminating providers from Medicaid and CHIP that were terminated by Medicare or another state's Medicaid or CHIP program. To pay for this increased screening, a $500 fee will be imposed on most providers/suppliers enrolling in Medicare, Medicaid and CHIP for the first time, as well as currently enrolled entities revalidating their status.