Medicaid Physician Service Quality Improvement Act of 1990

Summary

Medicaid Physician Service Quality Improvement Act of 1990 - Directs the Secretary of Health and Human Services to establish a system for providing Medicaid (title XIX of the Social Security Act) physicians with unique identifying numbers. Amends the Medicaid program to require such numbers to be included in the claim for physician services in order for the claim to be paid. Requires contracts between States and any entity for the provision of hospital services to provide maintenance of sufficient patient encounter data to identify the physician who delivers services to patients in order for States to be reimbursed by the Federal Government. Requires State plans for medical assistance to maintain updated lists of all physicians who are certified to participate. Requires foreign medical graduates to pass the Foreign Medical Graduate Examination required for participation in the Medicare program (title XVIII of the Social Security Act) in order to be issued a unique identifying number. Amends the Medicaid program to establish minimum qualifications for billing for physician services to children and pregnant women, including: (1) certification in pediatrics and obstetrics; (2) affiliation with a hospital participating in Medicaid; or (3) having a consultation arrangement with a physician who is certified in such specialties. Requires hospitals which receive extra Medicare payments by reason of their serving a disproportionate share of low-income patients to extend admitting privileges to Medicaid physicians. Requires State plans for medical assistance to provide for: (1) quality of care reviews of high-volume physicians; and (2) the reporting of any negative action or finding regarding a health care practitioner or facility by any State licensing authority, peer review organization, or private accreditation entity.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

2 official files

• Introduced in House (text)

  Introduced in House · EN

  ViewDownloadOpen at official source

• Introduced in House

  summary · EN · 10 September 1990

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.