HR 3659 · 113th Congress · Health
To amend title XIX of the Social Security Act to clarify policy with respect to collecting reimbursement from third-party payers for medical assistance paid under the Medicaid program, and for other purposes.
Bill Progress
✓
Introduced2
Committee3
House Vote4
Senate5
EnactedLatest: Referred to the Subcommittee on Health.(2013-12-06)
Plain Language Summary
[AI summary unavailable — showing source text]
Amends title XIX (Medicaid) of the Social Security Act (SSA) to repeal the requirement that state plans for medical assistance pay for covered prenatal or preventive pediatric care services, or other covered services provided to an individual on whose behalf a state agency is enforcing child support, without regard to a third party's liability for payment for such services, and then seek reimbursement from the third party. Requires a state plan to require any contract with a managed care entity to specify whether the state is: (1) delegating to the entity all or some of its right of recovery for payment of an item or service, and (2) transferring to the entity all or some of the assignment to the state of any right of an individual or other entity to payment from a health insurer for an item or service. Requires any state that makes such a delegation or transfer to have in effect laws requiring such health insurers, as a condition of doing business, to: (1) provide the managed care entity certain information upon request; (2) accept the delegated right of recovery and the transferred assignment of rights; and (3) agree not to deny a claim submitted by a managed care entity, for whi…
Summarized by Claude AI · Non-partisan · For informational purposes only