H.R. 3716: Ensuring Access to Quality Medicaid Providers Act

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H.R. 3716: Ensuring Access to Quality Medicaid Providers Act

114th Congress · introduced 2015-10-08 · Health · Latest: Received in the Senate and Read twice and referred to the Committee on Finance.

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Official title

Ensuring Access to Quality Medicaid Providers Act

Plain summary

Ensuring Access to Quality Medicaid Providers Act (Sec. 2) This bill amends titles XIX (Medicaid) and XXI (Children's Health Insurance Program [CHIP]) of the Social Security Act to prohibit federal payment under Medicaid for nonemergency services furnished by providers whose participation in Medicaid, Medicare, or CHIP has been terminated. Under current law, a state must exclude from Medicaid participation any provider that has been terminated under any state's Medicaid program or under Medicare. The bill maintains those requirements and further requires a state to exclude from Medicaid participation any provider that has been terminated under CHIP. Furthermore, a state must exclude from CHIP participation any provider that has been terminated under Medicaid or Medicare. The bill also revises a state's reporting requirements with respect to terminating a provider under a state plan. A state shall require each Medicaid or CHIP provider, whether the provider participates on a fee-for-service (FFS) basis or within the network of a managed care organization (MCO), to enroll with the state by providing specified identifying information. When notifying the Department of Health and Human Services (HHS) that a provider has been terminated under a state plan, the state must submit this information as well as information regarding the termination date and reason. HHS shall review such termination notifications and, if appropriate, include them in a database or similar system, as specified by the bill. The bill prohibits federal payment under a state's Medicaid or CHIP program for services provided by an MCO unless: (1) the state has a system for notifying MCOs when a provider is terminated under Medicaid, Medicare, or CHIP; and (2) any contract between the state plan and an MCO provides that such providers be excluded from participation in the MCO provider network. HHS shall report to Congress on this bill's implementation. (Sec. 3) A state must publish and annually update a public directory of FFS providers participating under the state plan.

Congressional Research Service summary (Passed House amended), quoted unchanged (nonpartisan). Read the source.

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Alternatives

Needs sources: no published alternatives yet (for example a different bill, a law instead of an amendment, or keeping current law). We only show items backed by a published source. Suggest one.

How did my representative vote? · This bill's floor votes

Officials and money

Sponsor: Rep. Bucshon, Larry [R-IN-8] · 2 cosponsors

Cost estimate: CBO cost estimate: H.R. 3716, Ensuring Removal of Terminated Providers from Medicaid and CHIP Act (2016-02-02)

Cosponsors on this site

Peter Welch (D-VT)

Recorded votes

• House roll call 105 (2016): On Passage, HR3716 (2016-03-02): Passed

Sources

• Congressional Research Service summary (Passed House amended)
• Congress.gov
• Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-114hr3716.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/114/hr>

Record fed-us-cong114-hr3716 · catalog fed-us-congress-bills-cong114 · updated 2026-11-15 by psicol fed-bills-cong114