S. 2669 · 114th Congress
Ensuring Removal of Terminated Providers from Medicaidand CHIP Act
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Never voted on. It didn't reach a floor vote before the 114th Congress ended, so it expired. A bill has to be introduced again to be considered in a new Congress.
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CornynSponsor1 cosponsor · 1 D
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Ensuring Removal of Terminated Providers from Medicaid and CHIP Act
What it does: CRS summary · Introduced in Senate · Mar 10, 2016
Ensuring Removal of Terminated Providers from Medicaid and CHIP Act
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.
Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov
About this bill and sources
Official title: Ensuring Removal of Terminated Providers from Medicaidand CHIP Act
Latest action (Mar 10, 2016): Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S1441-1442)
Policy area: Health · Origin: Senate · Introduced: Mar 10, 2016
Official page on Congress.gov · Bill text (GovInfo) · Status record (XML)
No recorded floor vote found.