Sec. 71113. Federal payments to prohibited entities
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/bill/119/hr/1/eas/section-71113A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
No Federal funds that are considered direct spending and provided to carry out a State plan under title XIX of the Social Security Act or a waiver of such a plan shall be used to make payments to a prohibited entity for items and services furnished during the 1-year period beginning on the date of the enactment of this Act, including any payments made directly to the prohibited entity or under a contract or other arrangement between a State and a covered organization. In this section:
The term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— that, as of the first day of the first quarter beginning after the date of enactment of this Act— is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations (as in effect on the date of enactment of this Act), that is primarily engaged in family planning services, reproductive health, and related medical care; and provides for abortions, other than an abortion— if the pregnancy is the result of an act of rape or incest; or in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed; and for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act for medical assistance furnished in fiscal year 2023 made directly, or by a covered organization, to the entity or to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity or to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $800,000.
The term direct spending has the meaning given that term under section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 ( 2 U.S.C. 900(c) ). The term covered organization means a managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1396u–2(a)(1)(B) )) or a prepaid inpatient health plan or prepaid ambulatory health plan (as such terms are defined in section 1903(m)(9)(D) of such Act ( 42 U.S.C. 1396b(m)(9)(D) )).
The term State has the meaning given such term in section 1101 of the Social Security Act ( 42 U.S.C. 1301 ). For the purposes of carrying out this section, there are appropriated, out of any monies in the Treasury not otherwise appropriated, to the Administrator of the Centers for Medicare & Medicaid Services, $1,000,000 for fiscal year 2026, to remain available until expended.
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- 42 USC 1396u–2(a)(1)(B)
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Sec. 71113
Federal payments to prohibited entities
Cite42 USC 1396u–2(a)(1)(B)
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