To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid.

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8115 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 8115

To amend title XIX of the Social Security Act to allow for the deferral 
   or disallowance of portions of payments for certain managed care 
                       violations under Medicaid.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 23, 2024

 Mr. Sarbanes 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 allow for the deferral 
   or disallowance of portions of payments for certain managed care 
                       violations under Medicaid.

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

SECTION 1. ALLOWING FOR THE DEFERRAL OR DISALLOWANCE OF PORTIONS OF 
              PAYMENTS FOR CERTAIN MANAGED CARE VIOLATIONS UNDER 
              MEDICAID.

    (a) In General.--Section 1903(m)(2) of the Social Security Act (42 
U.S.C. 1396(m)(2)) is amended--
            (1) in subparagraph (A), by striking ``and (G)'' and 
        inserting ``(G), and (I)''; and
            (2) by adding at the end the following new subparagraph:
    ``(I)(i) In lieu of applying the payment prohibition under 
subparagraph (A) for a violation of any requirement described in such 
subparagraph, the Secretary may defer or disallow a portion of a 
payment to a State described in such subparagraph (as determined 
appropriate by the Secretary) if the Secretary finds that such a 
deferral or disallowance more appropriately reflects the scope of such 
violation than application of such prohibition.
    ``(ii) If the Secretary determines subsequent to a deferral or 
disallowance of a portion of a payment under clause (i) for a violation 
by an entity of any requirement described in subparagraph (A) that such 
deferral or disallowance was insufficient to bring such entity into 
compliance with such requirement, the Secretary may apply the payment 
prohibition under subparagraph (A).''.
    (b) Treatment of Certain State Managed Care Requirements.--Section 
1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (86), by striking ``and'' at the end;
            (2) in paragraph (87)(D), by striking the period and 
        inserting ``; and''; and
            (3) by inserting after paragraph (87) the following new 
        paragraph:
            ``(88) in the case the State elects the option to use 
        managed care under section 1932, provide for compliance with 
        the requirements of such section.''.
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