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house Bill H.R. 3716

Do the Feds Need to Ensure that Terminated Health Care Providers Don’t Receive Funds From Medicare, Medicaid or CHIP?

Argument in favor

Health care providers that have been terminated by Medicare, Medicaid, or CHIP shouldn't be receiving federal funds. This bill would lead to better coordination between federal agencies and states, which will save $28 million in tax dollars.

BTSundra's Opinion
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03/02/2016
If someone has been terminated, don't keep funding them. This is basic common sense for keeping down government waste.
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Loraki's Opinion
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12/27/2016
If health care providers are terminated from Medicare, Medicaid, CHIP, or any other medical program, it doesn't seem right for them to continue to get federal money. AND IT'S ANOTHER SPENDING CUT!!! I LIKE THAT!
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Mark's Opinion
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03/03/2016
Who had the bright idea not to make this mandatory to begin with. If that numbskull is still alive he/she needs to be put in jail.
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Argument opposed

State Medicaid programs are already subject to reporting requirements when they terminate providers. Excluding terminated providers from CHIP and Medicare won't make much difference.

Elinor's Opinion
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03/02/2016
Medicaid and Chip are supposedly run by states, NOT THE FEDERAL GOVERNMENT.
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Michael's Opinion
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03/03/2016
+ There are a few reasons against this: 1) this potentially limits payments to states, not providers directly; 2) the criteria for termination are not yet known, and it seems like the termination by one state for a state-specific rule could result in the termination by federal programs, which seem like TRAP laws could harm providers nation-wide; 3) the process for remediating a terminated status and being removed from the database doesn't seem clear in this bill or the law it is amending.
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Jim2423's Opinion
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03/02/2016
The federal government seems to be the easy element to cheat money out of. They are so slow on watching and almost impossible on catching anyone it just wouldn't work without the states doing their part.
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What is House Bill H.R. 3716?

This bill would prohibit federal payments from going to health care providers that have been terminated from participating in Medicaid, Medicare, or the Children’s Health Insurance Program (CHIP) for nonemergency services.

It also would provide states with additional assistance in identifying providers that are ineligible because of their termination from participating in another state’s Medicaid program or in Medicare, which they are required to do under current law.

Reporting requirements that come into effect when states terminate a provider from participating in Medicaid or CHIP would be revised to require providers to enroll in a state system by providing identifying information. When a state terminates a provider, they’d be required to notify the Dept. of Health and Human Services (HHS) by providing that identifying information along with the reason for, and date of termination. HHS would then include those termination notifications in a database or similar system.

States would be required to have a system for notifying a managed care organization (MCO) when a provider is terminated under Medicaid, Medicare, or CHIP. A contract between the state Medicaid program and an MCO must allow for terminated providers to be excluded from the MCO’s provider network.

Impact

Providers that are terminated from participation in Medicaid, Medicare, or CHIP; managed care organizations; states; and HHS.

Cost of House Bill H.R. 3716

$0.00
The CBO estimates that implementing this bill would reduce spending by $28 million over the 2016-2026.

More Information

In-Depth: Sponsoring Rep. Larry Bucshon (R-IN) was quoted in the Morning Consult that this legislation would save taxpayers an estimated “tens of millions of dollars” because it seeks “to hold accountable bad actors in Medicaid and the Children’s Health Insurance Program.”

The House Energy and Commerce Committee advanced this legislation by voice vote, and it was introduced in a bipartisan fashion by Rep. Bucshon, Rep. Peter Welch (D-VT) and Rep. G.K. Butterfield (D-NC).



Media:

Summary by Eric Revell
(Photo Credit: Flickr user StockMonkeys.com)

AKA

Ensuring Access to Quality Medicaid Providers Act

Official Title

To amend title XIX of the Social Security Act to require States to provide to the Secretary of Health and Human Services certain information with respect to provider terminations, and for other purposes.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed March 2nd, 2016
    Roll Call Vote 406 Yea / 0 Nay
      house Committees
      Committee on Energy and Commerce
      Health
    IntroducedOctober 8th, 2015

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    If someone has been terminated, don't keep funding them. This is basic common sense for keeping down government waste.
    Like (16)
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    If health care providers are terminated from Medicare, Medicaid, CHIP, or any other medical program, it doesn't seem right for them to continue to get federal money. AND IT'S ANOTHER SPENDING CUT!!! I LIKE THAT!
    Like (8)
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    Who had the bright idea not to make this mandatory to begin with. If that numbskull is still alive he/she needs to be put in jail.
    Like (6)
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    Seems silly to ask this question. Of coarse the Government should stop terminated providers from Federal funds. But Ho Hum, it's only pocket change!
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    Very commonsense measure to prevent against wasteful government spending, which we already have plenty of. I can't see any possible opposition to this bill, it should receive unanimous bipartisan support.
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    Apparently, a number of companies have been submitting bills to federal programs (like Medicare, Medicaid or other Childrens' Health programs) after being removed from those programs. That is fraud, pure & simple, & needs to be stopped. This can easily be facilitated by a little communication between states & the federal government. While valid claims/bills need to be paid according to contractual obligations, this legislation can help stop greedy corporations from cajoling even more money from the taxpayers & government coffers.
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    Medicaid and Chip are supposedly run by states, NOT THE FEDERAL GOVERNMENT.
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    + There are a few reasons against this: 1) this potentially limits payments to states, not providers directly; 2) the criteria for termination are not yet known, and it seems like the termination by one state for a state-specific rule could result in the termination by federal programs, which seem like TRAP laws could harm providers nation-wide; 3) the process for remediating a terminated status and being removed from the database doesn't seem clear in this bill or the law it is amending.
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    I see 28 million reasons to vote yes on this bill!
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    Hmm - making sure those who should not be paid don't get paid. This shouldn't require a vote for common sense.
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    This is bipartisan legislation that is intended to foster efficient government and cost effective spending. This is the epitome of the "no-brainer".
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    So long as there are no ear marks on this bill.
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    The job of the Feds is to protect and serve the American people, and when it comes to the health of our citizens, nothing is more important. This is why it is essential that our taxpayer dollars we put into programs like Medicaid and Medicare are being used properly; no funds should go to a terminated health care provider, because it is most likely that those funds will not be used for their primary reason, to provide affordable healthcare for Americans. Government needs to know where Medicaid/Medicare Funds are going.
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    The reasons to vote against this only make me wonder why we wouldn't vote for it. It's not overregulation, it doesn't cost anything, and it appears to be tying up loose ends. Would be nice to know if there any any riders or not though. Those can ruin a perfectly sensible bill.
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    It is amazing to me that this isn't automatic already. Yes, kick these people out of tax payer funded programs.
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    The bill is here and it makes sense so why not. This makes double sure we don't waste those funds.
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    This should be a byproduct of being terminated, I would think. I mean, if your name is removed from the list of participating providers why would you keep getting funds? Seems to me that many software programs being use for these agencies should be recoded to make these changes automatically.
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    If they don't support Medicare, why should the Government give them money. They have the option
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    That's are tax money if they don't do the work are taxes should not be spent on it
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    Doh! (Head slap)
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