US SB2027 | 2017-2018 | 115th Congress

Status

Spectrum: Partisan Bill (Republican 1-0)
Status: Introduced on October 26 2017 - 25% progression, died in committee
Action: 2017-10-26 - Read twice and referred to the Committee on Finance.
Pending: Senate Finance Committee
Text: Latest bill text (Introduced) [PDF]

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.

Tracking Information

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Title

Medicaid Third Party Liability Act

Sponsors


History

DateChamberAction
2017-10-26SenateRead twice and referred to the Committee on Finance.

Same As/Similar To

HB938 (Related) 2017-02-10 - Referred to the Subcommittee on Health.
HB3921 (Related) 2017-10-23 - Placed on the Union Calendar, Calendar No. 263.

Subjects


US Congress State Sources


Bill Comments

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