A bill to amend title XIX of the Social Security Act to provide for medicaid provider improvements.

Summary

Amends title XIX (Medicaid) of the Social Security Act to require States to provide for the receipt and initial processing of Medicaid applications at locations other than those used for the receipt and processing of applications for Aid to Families with Dependent Children under part A of title IV such as hospitals or clinics providing covered services to Medicaid applicants. Prohibits States from discontinuing a child's Medicaid benefits until it is determined that the child is not eligible for such benefits on any basis. Prohibits the application of fixed durational limits to medically necessary inpatient hospital services for all Medicaid-eligible individuals regardless of age. Prohibits aggregate or institutional volume caps which would limit medically necessary days or result in arbitrary reductions in established payment rates for days exceeding such caps. Prohibits the waiver of such prohibitions to promote cost-effectiveness and efficiency. Requires outlier adjustments under State prospective payment plans for medically necessary inpatient hospital services for very high cost or exceptionally lengthy cases regardless of the age of the Medicaid-eligible patient. Requires a uniform national minimum Medicaid payment adjustment for disproportionate share hospitals. Allows State flexibility in setting adjustments for different types of disproportionate share providers. Prohibits application of visit limits to medically necessary covered outpatient services provided to individuals in disproportionate share hospitals as defined by the States under current law for inpatient payment adjustment. Requires States to adjust payments for outpatient services provided to individuals by disproportionate share hospitals. Prohibits the waiver of such provisions to promote cost-effectiveness and efficiency. Directs the General Accounting Office to conduct a study and report to the Congress on Medicaid hospital reimbursement comparing payment levels with the cost of providing care to Medicaid patients.

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

Timeline

1. 27 October 1990

   Introduced

   Read twice and referred to the Committee on Finance.

   Source: IntroReferral

2. 27 October 1990

   Introduced

   Introduced in Senate

   Source: IntroReferral

Votes

No vote records are attached yet.

Versions

• Introduced in Senate · undated · Official file

Documents

2 official files

• Introduced in Senate (text)

  Introduced in Senate · EN

  ViewDownloadOpen at official source

• Introduced in Senate

  summary · EN · 27 October 1990

  Open at official source

Sponsors

• Sen. Riegle, Donald W., Jr. [D-MI] · D · Sponsor
• Sen. Chafee, John H. [R-RI] · R · Sponsor
• · ssfi00 · Standing

Related records

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