US Congress House Bill 938 (Prior Session Legislation)

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Spectrum: Partisan Bill (Republican 3-0)
Status: Introduced on February 7 2017 - 25% progression, died in committee
Action: 2017-02-10 - Referred to the Subcommittee on Health.
Pending: House Subcommittee on Health Committee
Text: Latest bill text (Introduced) [PDF]

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.

Medicaid Third Party Liability Act

Rep. Michael Burgess [R-TX]

Rep. Bill Flores [R-TX]

Rep. Brett Guthrie [R-KY]

Date	Chamber	Action
2017-02-10	House	Referred to the Subcommittee on Health.
2017-02-07	House	Referred to the House Committee on Energy and Commerce.
2017-02-07	House	Introduced in House

HB3921 (Related) 2017-10-23 - Placed on the Union Calendar, Calendar No. 263.
SB2027 (Related) 2017-10-26 - Read twice and referred to the Committee on Finance.

Type	Source
Summary	https://www.congress.gov/bill/115th-congress/house-bill/938/all-info
Text	https://www.congress.gov/115/bills/hr938/BILLS-115hr938ih.pdf