Fair Pay to Medicaid Providers Act of 2011

Fair Pay to Medicaid Providers Act of 2011 - Amends title XIX (Medicaid) of the Social Security Act to declare that a state plan shall not be in compliance with Medicaid prompt pay requirements unless it applies such requirements to claims relating to items and services furnished by any eligible person or entity in the same or similar manner as the plan applies such requirements to services furnished by a health care practitioner through an individual or group practice or through shared health facilities.

[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3587 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 3587

   To amend title XIX of the Social Security Act to provide for the 
 application of Medicaid prompt pay requirement to claims for payment 
 for covered items and services furnished by any Medicaid health care 
                                entity.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 7, 2011

Mr. Bilbray (for himself and Ms. Eshoo) 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 provide for the 
 application of Medicaid prompt pay requirement to claims for payment 
 for covered items and services furnished by any Medicaid health care 
                                entity.

    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 ``Fair Pay to Medicaid Providers Act 
of 2011''.

SEC. 2. APPLICATION OF MEDICAID PROMPT PAY REQUIREMENTS TO ALL MEDICAID 
              HEALTH CARE ENTITIES.

    (a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended in subsection (a), in the matter following paragraph 
(83), by striking ``For purposes of this title'' and inserting 
``Subject to the previous sentence, a State plan shall not be in 
compliance with the requirement of clause (A) of paragraph (37) unless 
(i) such plan applies such requirement to claims for payment made for 
items and services covered under the plan and furnished by any person 
or entity eligible for payment under such plan (insofar as such person 
or entity is paid under this title on the basis of submission of 
claims) in the same or similar manner (but applying the same timeframes 
specified under such clause) as such plan applies such requirement to 
such services furnished by a practitioner described in such clause; and 
(ii) such plan provides for quarterly reports to be submitted by the 
State to the Secretary, presented by provider type, on the extent to 
which the State during each month of the previous quarter was in 
compliance with the requirement under such clause, including as applied 
under this sentence. For purposes of this title''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to claims made for covered services after the date of the 
enactment of this Act.
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