S 1787 · 113th Congress · Health
Medicaid Managed Care Responsibility and Equity Act
Bill Progress
✓
Introduced2
Committee3
Senate Vote4
House5
EnactedLatest: Read twice and referred to the Committee on Finance.(2013-12-10)
Plain Language Summary
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Medicaid Managed Care Responsibility and Equity Act - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act (SSA) with respect to managed care requirements. Requires a minimum medical loss ratio of at least 85% for Medicaid and CHIP managed care plans under contracts between a state and a managed medical care entity (health maintenance organization), but a minimum ratio of only 80% for an entity in which at least 10% of the enrollees are optional targeted low-income children. Prescribes administrative penalties for failure to maintain such ratios. Applies the same minimum medical loss ratios to a state child health (CHIP) plan, except for a medical loss ratio of at least 80% for managed care organizations.…
Summarized by Claude AI · Non-partisan · For informational purposes only