Ask AI
Bill114th CongressFiled Oct 8, 2015Health
H.R. 3716

Ensuring Access to Quality Medicaid Providers Act

Bill journey · stage 2 of 5

Under committee review

Filed
Comm.
Floor
Both
Law

What it doesSummary passed house amended (Mar 2, 2016)

Ensuring Access to Quality Medicaid Providers Act

(Sec. 2) 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.

HHS shall report to Congress on this bill's implementation.

(Sec. 3) A state must publish and annually update a public directory of FFS providers participating under the state plan.

What just happenedMar 3, 2016

Received in the Senate and Read twice and referred to the Committee on Finance.

Who’s behind it

Rep. Bucshon, Larry [R-IN-8](R-IN)Sponsor
2 cosponsors2 D
Read on Congress.gov
2cosponsors2committees31actions1amendments4related bills7subjects
  1. Mar 3, 2016IntroReferral

    Received in the Senate and Read twice and referred to the Committee on Finance.

    Finance Committee
  2. Mar 2, 2016FloorH38310

    Motion to reconsider laid on the table Agreed to without objection.

  3. Mar 2, 2016FloorH37100

    On passage Passed by the Yeas and Nays: 406 - 0 (Roll no. 105).

  4. Mar 2, 2016Floor8000

    Passed/agreed to in House: On passage Passed by the Yeas and Nays: 406 - 0 (Roll no. 105).

  5. Mar 2, 2016FloorH30000

    Considered as unfinished business. (consideration: CR H1104)

  6. Mar 2, 2016FloorH8D000

    UNFINISHED BUSINESS - The Chair announced that the unfinished business was the question of passage of H.R. 3716 which had been debated earlier and on which further proceedings had been postponed.

  7. Mar 2, 2016FloorH8D000

    POSTPONED PROCEEDINGS - The Chair put the question on passage of H.R. 3716 and by voice vote, announced that the ayes had prevailed. Mr. Bucshon demanded the yeas and nays and the Chair postponed further proceedings on the question of passage of the bill until a time to be announced.

  8. Mar 2, 2016FloorH34400

    The House adopted the amendment in the nature of a substitute as agreed to by the Committee of the Whole House on the state of the Union.

  9. Mar 2, 2016FloorH35000

    The previous question was ordered pursuant to the rule. (consideration: CR H1103)

  10. Mar 2, 2016FloorH32600

    The House rose from the Committee of the Whole House on the state of the Union to report H.R. 3716.

  11. Mar 2, 2016FloorH8D000

    DEBATE - Pursuant to the provisions of H.Res. 632, the Committee of the Whole proceeded with 10 minutes of debate on the Bucshon amendment No. 1, as modified.

  12. Mar 2, 2016FloorH8D000

    GENERAL DEBATE - The Committee of the Whole proceeded with one hour of general debate on H.R. 3716.

  13. Mar 2, 2016FloorH32400

    The Speaker designated the Honorable George Holding to act as Chairman of the Committee.

  14. Mar 2, 2016FloorH32020

    House resolved itself into the Committee of the Whole House on the state of the Union pursuant to H. Res. 632 and Rule XVIII.

  15. Mar 2, 2016FloorH8D000

    Rule provides for consideration of H.R. 3716 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Specified amendments are in order. It shall be in order to consider as an original bill for the purpose of amendment under the five-minute rule an amendment in the nature of a subsitute consisting of the text of Rules Committee Print 114-45.

  16. Mar 2, 2016FloorH30000

    Considered under the provisions of rule H. Res. 632. (consideration: CR H1097-1103; text of amendment in the nature of a substitute: CR H1101-1102)

  17. Mar 2, 2016FloorH1L220

    Rule H. Res. 632 passed House.

  18. Mar 1, 2016FloorH1L210

    Rules Committee Resolution H. Res. 632 Reported to House. Rule provides for consideration of H.R. 3716 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Specified amendments are in order. It shall be in order to consider as an original bill for the purpose of amendment under the five-minute rule an amendment in the nature of a subsitute consisting of the text of Rules Committee Print 114-45.

  19. Feb 23, 2016CalendarsH12410

    Placed on the Union Calendar, Calendar No. 326.

  20. Feb 23, 2016CommitteeH12200

    Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-427.

    Energy and Commerce Committee
  21. Feb 23, 2016Committee5000

    Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-427.

    Energy and Commerce Committee
  22. Nov 18, 2015Committee

    Ordered to be Reported (Amended) by Voice Vote.

    Energy and Commerce Committee
  23. Nov 18, 2015Committee

    Committee Consideration and Mark-up Session Held.

    Energy and Commerce Committee
  24. Nov 17, 2015Committee

    Committee Consideration and Mark-up Session Held.

    Energy and Commerce Committee
  25. Nov 4, 2015Committee

    Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote .

    Health Subcommittee
  26. Nov 4, 2015Committee

    Subcommittee Consideration and Mark-up Session Held.

    Health Subcommittee
  27. Nov 3, 2015Committee

    Subcommittee Consideration and Mark-up Session Held.

    Health Subcommittee
  28. Oct 9, 2015Committee

    Referred to the Subcommittee on Health.

    Health Subcommittee
  29. Oct 8, 2015IntroReferralH11100

    Referred to the House Committee on Energy and Commerce.

    Energy and Commerce Committee
  30. Oct 8, 2015IntroReferralIntro-H

    Introduced in House

  31. Oct 8, 2015IntroReferral1000

    Introduced in House

Passed House amendedMar 2, 201636

Ensuring Access to Quality Medicaid Providers Act

(Sec. 2) 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.

HHS shall report to Congress on this bill's implementation.

(Sec. 3) A state must publish and annually update a public directory of FFS providers participating under the state plan.

Reported to House with amendment(s)Feb 23, 201617

Ensuring Removal of Terminated Providers from Medicaid and CHIP Act

(Sec. 2) 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 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.

Introduced in HouseOct 8, 2015

Ensuring Terminated Providers are Removed 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 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 include such termination notifications in a database or similar system, as specified by the bill.

A state must have a system for notifying MCOs when a provider is terminated under Medicaid, Medicare, or CHIP. A contract between the state plan and an MCO must provide that such providers be excluded from participation in the MCO provider network.

Ensuring Access to Quality Medicaid Providers Act — Informed