The Ensuring Access to Quality Medicaid Providers Act (H.R. 3716) has passed the House with unanimous support. March 2, 2016, saw the passing of this bill, which requires the reporting of terminated providers in Medicare to the Federal government. Also required by the act is that patients be given a list of participating Medicaid providers. The bill seeks to keep providers from taking part in Federal health programs after being terminated from a state sponsored Medicaid or Medicare program.
The bill was brought before the house on October 8, 2015 and presented by Rep. Larry Bucshon (R-IN). It was co-sponsored by Rep. Peter Welch (D-VT) and Rep. G. K. Butterfield (D-NC). The bill would be used to amend Medicaid and the Children’s Health Insurance Program (CHIP) to prevent Medicaid payment for non-emergency services by providers whose participation in either of the health programs, or CHIP, has been terminated.
H.R. 3716 additionally requires the state to remove any provider from consideration after they have been terminated under CHIP from Medicaid participation, and if they have been terminated under Medicaid or Medicare from CHIP participation. States will be required to put up information such as date and reason for the termination into a publicly available database that is provided by HHS.
In addition, the state must have a notification system in place for alerting managed care organizations (MCO) of a provider being terminated under Medicaid, Medicare, or CHIP. These providers should also be excluded from taking part in the MCO provider network. There would also be access to n HHS database of the participating Medicaid providers.
The White house has issued a statement where it announces support for H.R. 3716. In it, they stated confidence that the bill would further empower states to locate health care providers that have been terminated from Medicare participation, or in another state’s Medicaid or CHIP program. The Administration holds that the bill would bring down chances of terminated providers participating in these programs. The White House also said that CBO estimates the bill to reduce federal spending by the $28 million over a decade.
Although this bill has the support of the house and has passed it, it still needs to pass in the Senate. By March 3, 2016, the Senate has received the bill and referred it to the Committee on Finance, awaiting further action. There hasn’t been word about whether the Committee will consider it.