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Medicaid Third Party Liability Act

12/30/2022, 4:18 AM

Summary of Bill HR 6622

Bill 117 HR 6622, also known as the Medicaid Third Party Liability Act, is a piece of legislation currently being considered by the US Congress. The purpose of this bill is to address issues related to third party liability in the Medicaid program.

Under the current Medicaid system, the federal government and states share the cost of providing healthcare coverage to low-income individuals. However, there are instances where a third party, such as an insurance company or employer, may also be responsible for covering some of the costs associated with a Medicaid beneficiary's healthcare.

The Medicaid Third Party Liability Act aims to improve coordination between Medicaid and third party payers in order to ensure that Medicaid is not paying for services that should be covered by another party. This would help to reduce costs for the Medicaid program and ensure that taxpayer dollars are being used efficiently. Specifically, the bill includes provisions that would require Medicaid to more actively pursue reimbursement from third parties when they are responsible for covering the cost of a beneficiary's healthcare services. It also includes measures to improve data sharing and coordination between Medicaid and third party payers. Overall, the Medicaid Third Party Liability Act seeks to strengthen the financial integrity of the Medicaid program and ensure that it is able to continue providing essential healthcare services to those in need. It is currently being debated in Congress, and its ultimate fate will depend on the support it receives from lawmakers.

Congressional Summary of HR 6622

Medicaid Third Party Liability Act

This bill modifies requirements relating to Medicaid third-party liability.

Current law generally requires legally liable third parties (e.g., health insurers) to pay claims before Medicaid. However, Medicaid must pay first (and seek reimbursement from liable third parties) for claims for (1) preventive pediatric care, and (2) services for an individual for whom child support enforcement is being conducted by the state. The bill repeals these exceptions.

Current law also requires state Medicaid programs to take all reasonable measures to identify legally liable third parties. The bill specifically prohibits federal Medicaid payment for services to individuals for whom third-party insurance information was not obtained and verified by the state.

Current Status of Bill HR 6622

Bill HR 6622 is currently in the status of Bill Introduced since February 7, 2022. Bill HR 6622 was introduced during Congress 117 and was introduced to the House on February 7, 2022.  Bill HR 6622's most recent activity was Referred to the Subcommittee on Health. as of February 8, 2022

Bipartisan Support of Bill HR 6622

Total Number of Sponsors
1
Democrat Sponsors
0
Republican Sponsors
1
Unaffiliated Sponsors
0
Total Number of Cosponsors
0
Democrat Cosponsors
0
Republican Cosponsors
0
Unaffiliated Cosponsors
0

Policy Area and Potential Impact of Bill HR 6622

Primary Policy Focus

Health

Alternate Title(s) of Bill HR 6622

Medicaid Third Party Liability Act
Medicaid Third Party Liability Act
To amend title XIX of the Social Security Act to provide clarification with respect to the liability of third party payers for medical assistance paid under the Medicaid program, and for other purposes.

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