Summary: S.1787 — 113th Congress (2013-2014)All Information (Except Text)

There is one summary for S.1787. Bill summaries are authored by CRS.

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Introduced in Senate (12/10/2013)

Medicaid Managed Care Responsibility and Equity Act - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act (SSA) with respect to managed care requirements.

Requires a minimum medical loss ratio of at least 85% for Medicaid and CHIP managed care plans under contracts between a state and a managed medical care entity (health maintenance organization), but a minimum ratio of only 80% for an entity in which at least 10% of the enrollees are optional targeted low-income children.

Prescribes administrative penalties for failure to maintain such ratios.

Applies the same minimum medical loss ratios to a state child health (CHIP) plan, except for a medical loss ratio of at least 80% for managed care organizations.