To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid.
Latest Action
Referred to the Subcommittee on Health.
Official Summary
Official summary has not been imported yet.
GovScope Watchdog™
AI Government Intelligence™This bill proposes an amendment to title XIX of the Social Security Act to permit the deferral or disallowance of certain Medicaid managed care payments when violations occur. It aims to provide a mechanism for withholding or reducing payments to managed care organizations under Medicaid if they fail to comply with specific regulatory requirements. The bill was introduced in the House during the 118th Congress but lacks a detailed official summary or full text publicly available. The latest procedural action was referral to the House Subcommittee on Health, and the bill ultimately failed or expired without enactment.
The bill sought to enhance enforcement tools for Medicaid managed care compliance by allowing payment deferrals or disallowances but did not advance beyond subcommittee review and expired.
- Amends title XIX of the Social Security Act related to Medicaid managed care payments.
- Allows deferral or disallowance of payments for certain managed care violations under Medicaid.
- Referred to the House Subcommittee on Health but did not progress and expired.
['Medicaid program administrators who gain additional enforcement options.', 'Potentially Medicaid beneficiaries if managed care compliance improves.', 'Federal and state health agencies overseeing Medicaid managed care.']
["Implementation challenges in defining and identifying 'certain managed care violations'.", 'Potential administrative burden on Medicaid agencies to monitor and enforce payment deferrals or disallowances.', 'Unclear fiscal impact due to lack of detailed provisions or cost estimates.', 'Oversight mechanisms for ensuring fair application of payment penalties are not specified.']
The bill was introduced in the House during the 118th Congress and referred to the Subcommittee on Health. It addresses Medicaid managed care, a significant component of federal and state health policy. The bill did not advance beyond subcommittee referral and expired, indicating limited legislative momentum or prioritization during the session.
Hidden impact flags detected: 2
GovScope reviewed 2 policy-risk categories. Hover for a quick definition. Click detected flags for bill-specific details.
['Potential improvement in managed care compliance due to financial penalties.', 'Increased administrative workload for Medicaid agencies to monitor and enforce payment adjustments.', 'Possible financial strain on managed care organizations facing payment deferrals or disallowances.']
The absence of a full bill text and official summary limits comprehensive analysis. Transparency would be improved by public availability of detailed provisions, definitions of violations, enforcement procedures, and fiscal impact assessments. Oversight considerations include ensuring fair and consistent application of payment penalties and monitoring administrative burden on Medicaid agencies.
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