Sponsor
Al Green
Representative · D-TX
Representative · D-TX
The bill clarifies and standardizes Medicaid payment rules to improve timely, predictable reimbursements for states, beneficiaries, and providers but risks higher payment obligations, short-term access disruptions, and administrative costs during implementation.
State Medicaid programs and Medicaid beneficiaries will get clearer payment rules that can speed and regularize reimbursements for covered services beginning at enactment.
Hospitals and clinics will have more predictable Medicaid payment treatment, which can reduce billing disputes and lower administrative burden for providers.
Medicaid beneficiaries could face short-term payment interruptions or access disruptions if States delay implementing or reinterpret the amended payment rules.
State Medicaid programs and the federal budget could face increased payment obligations depending on how the new text changes payment calculations, potentially raising costs for taxpayers and state budgets.
Providers will likely need to update billing systems and compliance practices immediately for items/services on or after enactment, creating one-time administrative costs and operational disruption.
Based on analysis of 2 sections of legislative text.
Substantively inserts new text into 42 U.S.C. § 1396b(a)(3)(E)(ii), altering Medicaid payment treatment for items and services furnished on or after enactment.
Official title: To amend title XIX of the Social Security Act to provide incentives for education on the risk of renal medullary carcinoma in individuals who are receiving medical assistance under such title and who have sickle cell disease.
Introduced January 3, 2025 by Al Green · Last progress January 3, 2025
Amends the Medicaid payment statute by inserting additional text into 42 U.S.C. § 1396b(a)(3)(E)(ii), changing the content or placement of that provision and affecting how Medicaid payment calculations apply. The change is effective for items and services furnished on or after the date of enactment. The Act also provides a short title naming it the Byron Nash Renal Medullary Carcinoma Awareness Act of 2023.