Medicaid Third Party Liability Act

Summary

Medicaid Third Party Liability Act This bill alters provisions related to third-party liability for medical assistance paid under the Medicaid program. Specifically, with respect to such liability, the bill: expands the definition of "responsible third party" to include, among other health insurers, the TRICARE program; eliminates special rules with respect to certain services provided to children; requires the inclusion, in a contract between a state Medicaid program and a health insurer, of certain information regarding whether the state is delegating or transferring to the insurer a right of third-party recovery;  provides for the treatment as overpayment of reimbursements made by a responsible third party to a health insurer; disallows a responsible third party from denying a state's claim solely on the basis of a failure to obtain a prior authorization;  imposes a timeline for a responsible third party to respond to a state's inquiry regarding a claim for payment; provides for reductions to a state Medicaid program's federal matching rate if the state fails to comply with third-party insurance requirements; and modifies other provisions related to third-party liability under the Medicaid program. Third-party liability requirements applicable under Medicaid shall also apply under the Children's Health Insurance Program (CHIP). The Centers for Medicare & Medicaid Services must: publish on its website, and annually update, best practices for assessing third-party liability; monitor and analyze efforts to assess that liability; in consultation with states, develop and make available a model uniform reporting field for identifying information related to responsible third parties; and provide other specified information and guidance to states.

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

Timeline

1. 7 February 2017

   Introduced

   Referred to the House Committee on Energy and Commerce.

   Source: IntroReferral

2. 7 February 2017

   Introduced

   Introduced in House

   Source: IntroReferral

3. 7 February 2017

   Introduced

   Introduced in House

   Source: IntroReferral

4. 10 February 2017

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

Votes

No vote records are attached yet.

Versions

• Introduced in House · 7 February 2017 · Download file

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 7 February 2017

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 7 February 2017

  ViewDownloadOpen at official source

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• Introduced in House

  summary · EN · 7 February 2017

  Open at official source

  Leesvertaling

  Vertaal dit document naar jouw taal. PoliticalRepo bewaart geen aparte kopie per EU-taal.

  Vertaal naarNL · DutchDE · GermanFR · FrenchES · SpanishIT · ItalianPL · PolishPT · PortugueseSV · SwedishDA · DanishFI · FinnishEL · GreekCS · CzechHU · HungarianRO · RomanianBG · BulgarianHR · CroatianSK · SlovakSL · SlovenianLT · LithuanianLV · LatvianET · EstonianGA · IrishMT · Maltese

  Vertaal document

  Documentvertaling op verzoek met downloadbare PDF (logo + link naar de officiële bron). Het bronbestand blijft leidend.

Sponsors

• Rep. Burgess, Michael C. [R-TX-26] · R · Sponsor
• Rep. Flores, Bill [R-TX-17] · R · Sponsor
• Rep. Guthrie, Brett [R-KY-2] · R · Cosponsor
• · hsif00 · Standing

Related records

• related to ← HEALTHY KIDS Act
• related to ← Medicaid Third Party Liability Act