Sec. 44107. Removing good faith waiver for payment reduction related to certain erroneous excess payments under Medicaid

298 words·~1 min read·/bill/119/hr/1/eh/section-44107

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Section 1903(u)(1) of the Social Security Act ( 42 U.S.C. 1396b(u)(1) ) is amended— in subparagraph (B)— by striking The Secretary and inserting Subject to clause (ii), the Secretary ; and by adding at the end the following new clause: The amount waived under clause

(i)for a fiscal year may not exceed an amount equal to the difference between— the amount of the reduction required under subparagraph

(A)for such fiscal year (without application of this subparagraph); and the sum of the erroneous excess payments for medical assistance described in subclauses

(I)and

(III)of subparagraph (D)(i) made for such fiscal year. ; in subparagraph (C), by striking he in each place it appears and inserting the Secretary in each such place; and in subparagraph (D)— in clause (i)— in subclause (I), by striking and at the end; in subclause (II), by striking the period at the end and inserting , and ; and by adding at the end the following new subclause: payments (other than payments described in subclause (I)) for items and services furnished to an eligible individual who is not eligible for medical assistance under the State plan (or a waiver of such plan) with respect to such items and services. ; and by adding at the end the following new clause: In determining the amount of erroneous excess payments for medical assistance under clause (i), the Secretary shall include any payments described in such clause that are identified under the payment error rate measurement

(PERM)program, the Medicaid Eligibility Quality Control

(MEQC)program, an audit conducted by the Inspector General of the Department of Health and Human Services, or any other independent audit made by the Secretary. . The amendments made by subsection

(a)shall apply beginning with respect to fiscal year 2030.

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42 USC 1396b(u)(1)

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Sec. 44107

Removing good faith waiver for payment reduction related to certain erroneous excess payments under Medicaid

Cite42 USC 1396b(u)(1)

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