Reducing Unnecessary Emergency Room Visits under Medicaid Act

This bill increases the maximum allowable cost-sharing or similar charge that a state Medicaid program may impose, for outpatient services received at a hospital emergency room, from up to twice the nominal amount (currently $4) to up to $25.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1323 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 1323

  To amend title XIX of the Social Security Act to reduce unnecessary 
           emergency room visits under the Medicaid program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 2, 2017

  Mr. Collins of New York (for himself and Mr. Flores) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act to reduce unnecessary 
           emergency room visits under the Medicaid program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Reducing Unnecessary Emergency Room 
Visits under Medicaid Act''.

SEC. 2. STATE OPTION TO IMPOSE HIGHER COST SHARING FOR NONEMERGENCY USE 
              OF EMERGENCY ROOM SERVICES.

    (a) In General.--Section 1916 of the Social Security Act (42 U.S.C. 
1396o) is amended--
            (1) in subsection (a)(3), by striking ``up to twice the 
        nominal amount'' and inserting ``up to $25''; and
            (2) in subsection (b)(3), by striking ``up to twice the 
        nominal amount'' and inserting ``up to $25''.
    (b) State Option for Alternative Premiums and Cost Sharing.--
Section 1916A(e)(2) of the Social Security Act (42 U.S.C. 1396o-
1(e)(2)) is amended--
            (1) in subparagraph (A), by striking ``twice the amount 
        determined to be nominal under section 1916'' and inserting 
        ``the amount specified in paragraph (3) of subsection (a) or 
        (b) (as applicable) of section 1916 with respect to non-
        emergency services''; and
            (2) in subparagraph (B), by striking ``a nominal amount (as 
        otherwise determined under section 1916)'' and inserting ``the 
        amount specified in paragraph (3) of subsection (a) or (b) (as 
        applicable) of section 1916 with respect to non-emergency 
        services''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to items and services furnished on or after October 
1, 2017.
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