S.1787 - Medicaid Managed Care Responsibility and Equity Act113th Congress (2013-2014)
|Sponsor:||Sen. Rockefeller, John D., IV [D-WV] (Introduced 12/10/2013)|
|Committees:||Senate - Finance|
|Latest Action:||Senate - 12/10/2013 Read twice and referred to the Committee on Finance. (All Actions)|
This bill has the status Introduced
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Summary: S.1787 — 113th Congress (2013-2014)All Information (Except Text)
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.