[House Report 114-440]
[From the U.S. Government Publishing Office]


114th Congress   }                                      {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session      }                                      {      114-440

======================================================================

 
PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3716) 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

                                _______
                                

   March 1, 2016.--Referred to the House Calendar and ordered to be 
                                printed

                                _______
                                

               Mr. Burgess, from the Committee on Rules, 
                        submitted the following

                              R E P O R T

                       [To accompany H. Res. 632]

    The Committee on Rules, having had under consideration 
House Resolution 632, by a nonrecord vote, report the same to 
the House with the recommendation that the resolution be 
adopted.

                SUMMARY OF PROVISIONS OF THE RESOLUTION

    The resolution provides for consideration of H.R. 3716, the 
Ensuring Terminated Providers are Removed from Medicaid and 
CHIP Act, under a structured rule. The resolution provides one 
hour of general debate equally divided and controlled by the 
chair and ranking minority member of the Committee on Energy 
and Commerce. The resolution waives all points of order against 
consideration of the bill. The resolution makes in order as 
original text for purpose of amendment an amendment in the 
nature of a substitute consisting of the text of Rules 
Committee Print 114-45 and provides that it shall be considered 
as read. The resolution waives all points of order against that 
amendment in the nature of a substitute. The resolution makes 
in order only those further amendments printed in this report. 
Each such amendment may be offered only in the order printed in 
this report, may be offered only by a Member designated in this 
report, shall be considered as read, shall be debatable for the 
time specified in this report equally divided and controlled by 
the proponent and an opponent, shall not be subject to 
amendment, and shall not be subject to a demand for division of 
the question in the House or in the Committee of the Whole. The 
resolution waives all points of order against the amendments 
printed in this report. The resolution provides one motion to 
recommit with or without instructions.

                         EXPLANATION OF WAIVERS

    The waiver of all points of order against consideration of 
the bill includes a waiver of clause 3(e)(1) of rule XIII 
(``Ramseyer''), requiring a committee report accompanying a 
bill amending or repealing statutes to show, by typographical 
device, parts of statute affected. The waiver is provided 
because the submission provided by the Committee on Energy and 
Commerce was insufficient to meet the standards established by 
the rule in its current form. The Committee on Rules continues 
to work with the House Office of Legislative Counsel and 
committees to determine the steps necessary to comply with the 
updated rule.
    The waiver of all points of order against the amendment in 
the nature of a substitute made in order as original text 
includes a waiver of the following:
           Section 303 of the Congressional Budget Act, 
        which prohibits consideration of legislation providing 
        new budget authority for a fiscal year until the budget 
        resolution for that year has been agreed to; and
           Clause 10 of rule XXI, which prohibits the 
        consideration of a bill or amendment if it has the net 
        effect of increasing mandatory spending over the five-
        year or ten-year period. It is important to note that 
        while the waiver is necessary because the amendment 
        reduces the saving compared to the base bill, the 
        Congressional Budget Office has estimated that compared 
        to current law, the amendment will save $15 million 
        over 10 years.
    Although the resolution waives all points of order against 
the amendments printed in this report, the Committee is not 
aware of any points of order. The waiver is prophylactic in 
nature.

                SUMMARY OF THE AMENDMENTS MADE IN ORDER

    1. Bucshon (IN), Collins, Chris (NY), Welch (VT), Tonko 
(NY): MANAGER'S Makes technical changes to the bill. The 
amendment changes the short title to better capture both 
sections of the bill and changes the effective dates throughout 
the bill to ensure that states and the Secretary of Health and 
Human Services have the time necessary to correctly implement 
the provisions. The amendment adds a requirement for the 
Inspector General of the Department of Health and Human 
Services to report on implementation of the requirements 
regarding providers disenrolled for reasons related to fraud, 
integrity and quality. Finally, the amendments clarify that the 
fee-for-service provider directory is to include physicians 
and, at state option, other providers, and provides other 
information that could be included in the directory. (10 
minutes)
    2. Jackson Lee (TX): Provides that determination of 
ineligibility to work for a Medicaid or CHIP provider does not 
take effect until the deadline for appeal that determination 
has expired. (10 minutes)
    3. Jackson Lee (TX): Seeks information on the demographics 
of the people who are provided healthcare by terminated 
Medicaid Providers. (10 minutes)
    4. Moore, Gwen (WI): Requires states to correct on an 
expedited basis directory information regarding whether the 
provider is accepting new Medicaid patients. (10 minutes)

                    TEXT OF AMENDMENTS MADE IN ORDER

 1. An Amendment To Be Offered by Representative Bucshon of Indiana or 
                 His Designee, Debatable for 10 Minutes

  Page 1, lines 2 and 3, strike ``Ensuring Removal of 
Terminated Providers from Medicaid and CHIP Act'' and insert 
``Ensuring Access to Quality Medicaid Providers Act''.
  Page 1, lines 15 and 16, strike ``January 1, 2017'' and 
insert ``July 1, 2018''.
  Page 3, lines 1 and 2, strike ``the effective date of such 
termination specified in such notice'' and insert ``the date on 
which such termination is effective, as specified in the 
notice''.
  Page 3, line 16, strike ``Reporting requirements'' and insert 
``Contract requirement''.
  Page 3, line 20, strike ``State reporting requirements for 
managed care entities'' and insert ``Contract requirement for 
managed care entities''.
  Page 3, line 22, strike ``(A)'' and all that follows through 
``With respect'' and insert ``With respect''.
  Page 3, beginning on line 24, strike ``applicable), beginning 
on the later of the first day of the first plan year for such 
managed care entity that begins after the date of the enactment 
of this paragraph or January 1, 2017, the State shall require 
that such contract'' and insert ``applicable), no later than 
July 1, 2018, such contract shall''.
  Page 4, strike lines 12 through 21.
  Page 6, line 1, strike ``January 1, 2018'' and insert ``July 
1, 2018''.
  Page 6, line 17, strike ``the applicable date specified in 
subparagraph (A) of section 1932(d)(5)'' and insert ``July 1, 
2018''.
  Page 6, line 21, strike ``(i)''.
  Page 6, line 21, strike ``for the period specified in 
subparagraph (B) of such section, has a system in effect that 
meets'' and insert ``beginning on January 1, 2018, complies 
with''.
  Page 6, line 23, strike ``such subparagraph; and'' and all 
that follows through page 7, line 2 and insert ``section 
1932(d)(6)(A).''.
  Page 7, line 5, strike ``January 1, 2017'' and insert ``July 
1, 2017''.
  Page 10, line 15, strike ``paragraph (1)'' and insert 
``subparagraph (A)''.
  Page 10, line 21, strike ``paragraph (1)'' and insert 
``subparagraph (A)''.
  Page 10, lines 23 and 24, strike ``reporting requirements'' 
and insert ``contract requirement''.
  Page 11, after line 15, insert the following:
  (e) OIG Report.--Not later than March 31, 2020, the Inspector 
General of the Department of Health and Human Services shall 
submit to Congress a report on the implementation of the 
amendments made by this section. Such report shall include the 
following:
          (1) An assessment of the extent to which providers 
        who are included under subsection (II) of section 1902 
        of the Social Security Act (42 U.S.C. 1396a) (as added 
        by subsection (a)(3)) in the database or similar system 
        referred to in such subsection are terminated (as 
        described in subsection (kk)(8) of such section, as 
        added by subsection (a)(1)) from participation in all 
        State plans under title XIX of such Act.
          (2) Information on the amount of Federal financial 
        participation paid to States under section 1903 of such 
        Act in violation of the limitation on such payment 
        specified in subsections (i)(2)(D) and subsection 
        (m)(3) of such section, as added by subsection (a)(4).
          (3) An assessment of the extent to which contracts 
        with managed care entities under title XIX of such Act 
        comply with the requirement specified in section 
        1932(d)(5) of such Act, as added by subsection (a)(2).
          (4) An assessment of the extent to which providers 
        have been enrolled under section 1902(a)(78) or 
        1932(d)(6)(A) of such Act (42 U.S.C. 1396a(a)(78), 
        1396u-2(d)(6)(A)) with State agencies administering 
        State plans under title XIX of such Act.
  Page 12, lines 1 and 2, strike ``180 days after the date of 
the enactment of this paragraph'' and insert ``January 1, 
2017''.
  Page 12, line 10, strike ``a directory'' and all that follows 
through line 13 and insert the following: ``a directory of the 
physicians described in subsection (mm) and, at State option, 
other providers described in such subsection that--''
  Page 12, after line 13, insert the following:
                  ``(A) includes--''.
  Page 12, line 14, strike ``(A)'' and insert ``(i)''.
  Page 12, line 14, insert ``physician or'' before 
``provider''.
  Page 12, line 15, strike ``(i)'' and insert ``(I)''.
  Page 12, line 15, insert ``physician or'' before 
``provider''.
  Page 12, line 16, strike ``(ii)'' and insert ``(II)''.
  Page 12, line 16, insert ``physician or'' before 
``provider''.
  Page 12, line 17, strike ``(iii)'' and insert ``(III)''.
  Page 12, line 17, strike ``of the provider'' and insert ``at 
which the physician or provider provides services''.
  Page 12, line 18, strike ``(iv)'' and insert ``(IV)''.
  Page 12, line 18, insert ``physician or'' before 
``provider''.
  Page 12, line 20, strike ``(B)'' and insert ``(ii)''.
  Page 12, line 20, insert ``physician or'' before 
``provider''.
  Page 12, line 23, strike ``(i)'' and insert ``(I)''.
  Page 12, line 23, insert ``physician or'' before 
``provider''.
  Page 13, line 1, strike ``(ii)'' and insert ``(II)''.
  Page 13, line 1, insert ``the physician's'' before 
``provider's''.
  Page 13, line 3, insert ``physician or'' before ``provider''.
  Page 13, line 5, strike ``provider's office.'' and insert 
``physician's or provider's office; and''.
  Page 13, after line 5, insert the following:
                  ``(B) may include, at State option, with 
                respect to each such physician or provider--
                          ``(i) the Internet website of such 
                        physician or provider; or
                          ``(ii) whether the physician or 
                        provider is accepting as new patients 
                        individuals who receive medical 
                        assistance under this title.''.
  Page 13, line 6, strike ``Providers'' and insert ``Physician 
or Provider''.
  Page 13, line 10, strike ``Providers'' and insert ``Physician 
or Provider''.
  Page 13, line 10, strike ``A'' and insert ``A physician or''.
  Page 13, line 12, insert ``physician or'' before ``provider 
of''.
  Page 13, line 15, insert ``physician or'' before 
``provider''.
  Page 13, line 17, strike ``provider with the State agency, 
a'' and insert ``physician or provider with the State agency, a 
physician or''.
  Page 14, line 1, insert ``physician or'' before ``provider 
of''.
  Page 14, line 3, insert ``physician or'' before ``provider''.
  Page 14, beginning on line 10, strike ``in which all the 
individuals enrolled in the State plan under title XIX of the 
Social Security Act'' and insert ``(as defined for purposes of 
title XIX of the Social Security Act) in which all the 
individuals enrolled in the State plan under such title''.
  Page 15, line 3, insert ``of Health and Human Services'' 
after ``Secretary''.
  Page 15, line 12, strike ``section'' and insert ``Act''.
                              ----------                              


2. An Amendment To Be Offered by Representative Jackson Lee of Texas or 
                 Her Designee, Debatable for 10 Minutes

  Page 3 line 11, insert ``but only after any appeals deadline 
respecting such termination has passed'' after ``termination''.
                              ----------                              


3. An Amendment To Be Offered by Representative Jackson Lee of Texas or 
                 Her Designee, Debatable for 10 Minutes

  Page 7, after line 17, insert the following (and redesignate 
the succeeding paragraph accordingly):
          (6) Report on demographics.--The Secretary of Health 
        and Human Services, acting through the Centers for 
        Medicare & Medicaid Services, shall submit to Congress 
        an annual report on the following:
                  (A) The demographics of the providers of 
                services and other persons whose participation 
                in the program under title XIX of the Social 
                Security Act has been terminated and who are 
                included in the termination notification 
                database referred to in section 1902(ll) of the 
                Social Security Act, as added by paragraph (3).
                  (B) The demographics of the population 
                previously served by such providers and persons 
                under such title.
                              ----------                              


 4. An Amendment To Be Offered by Representative Moore of Wisconsin or 
                 Her Designee, Debatable for 10 Minutes

  Page 12, line 9, insert after ``annual basis'' the following: 
`` and correct on an expedited basis directory information 
described in subparagraph (A)(v) in cases where the State 
receives information indicating that such directory information 
is not accurate''.
  Page 12, line 17, strike ``and''.
  Page 12, after line 19, insert the following:
                          ``(v) information regarding whether 
                        the provider is accepting as new 
                        patients individuals who receive 
                        medical assistance under this title; 
                        and''.
  Page 12, line 22, strike ``regarding'' and all that follows 
through ``the provider's'' on page 13, line 1, and insert 
``regarding the provider's''.

                                  [all]