Ensuring Access to Quality Medicaid Providers Act

Hozzl · 2023-01-11T13:29:40Z

Explore the details of House Bill 3716 Ensuring Access to Quality Medicaid Providers Act currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on Health. Stay informed on legislative developments.

1/11/2023, 1:29 PM

Congressional Summary of HR 3716

Ensuring Access to Quality Medicaid Providers Act

(Sec. 2) This bill amends titles XIX (Medicaid) and XXI (Children's Health Insurance Program [CHIP]) of the Social Security Act to prohibit federal payment under Medicaid for nonemergency services furnished by providers whose participation in Medicaid, Medicare, or CHIP has been terminated.

Under current law, a state must exclude from Medicaid participation any provider that has been terminated under any state's Medicaid program or under Medicare. The bill maintains those requirements and further requires a state to exclude from Medicaid participation any provider that has been terminated under CHIP. Furthermore, a state must exclude from CHIP participation any provider that has been terminated under Medicaid or Medicare.

The bill also revises a state's reporting requirements with respect to terminating a provider under a state plan. A state shall require each Medicaid or CHIP provider, whether the provider participates on a fee-for-service (FFS) basis or within the network of a managed care organization (MCO), to enroll with the state by providing specified identifying information. When notifying the Department of Health and Human Services (HHS) that a provider has been terminated under a state plan, the state must submit this information as well as information regarding the termination date and reason. HHS shall review such termination notifications and, if appropriate, include them in a database or similar system, as specified by the bill.

The bill prohibits federal payment under a state's Medicaid or CHIP program for services provided by an MCO unless: (1) the state has a system for notifying MCOs when a provider is terminated under Medicaid, Medicare, or CHIP; and (2) any contract between the state plan and an MCO provides that such providers be excluded from participation in the MCO provider network.

HHS shall report to Congress on this bill's implementation.

(Sec. 3) A state must publish and annually update a public directory of FFS providers participating under the state plan.

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Current Status of Bill HR 3716

Bill HR 3716 is currently in the status of Bill Introduced since October 8, 2015. Bill HR 3716 was introduced during Congress 114 and was introduced to the House on October 8, 2015. Bill HR 3716's most recent activity was Received in the Senate and Read twice and referred to the Committee on Finance. as of March 3, 2016

Bipartisan Support of Bill HR 3716

Total Number of Sponsors

Democrat Sponsors

Republican Sponsors

Unaffiliated Sponsors

Total Number of Cosponsors

Democrat Cosponsors

Republican Cosponsors

Unaffiliated Cosponsors

Policy Area and Potential Impact of Bill HR 3716

Primary Policy Focus

Health

Potential Impact Areas

Child healthGovernment information and archivesHealth care costs and insuranceHealth personnelMedicaidMedicareState and local government operations

Alternate Title(s) of Bill HR 3716

Ensuring Access to Quality Medicaid Providers ActTo amend title XIX of the Social Security Act to require States to provide to the Secretary of Health and Human Services certain information with respect to provider terminations, and for other purposes.Ensuring Terminated Providers are Removed from Medicaid and CHIP ActEnsuring Removal of Terminated Providers from Medicaid and CHIP ActEnsuring Access to Quality Medicaid Providers Act

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