59–008 

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. 


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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) 


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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. 


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(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’’. 


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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’’. 


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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’’. 

Æ 


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