IB 
Union Calendar No. 326 
114TH CONGRESS 
2D SESSION 
H. R. 3716 
[Report No. 114–427] 
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. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 8, 2015 
Mr. BUCSHON (for himself, Mr. WELCH, and Mr. BUTTERFIELD) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce 
FEBRUARY 23, 2016 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on October 8, 2015] 
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A BILL 
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 ter-
minations, and for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ensuring Removal of 
Terminated Providers from Medicaid and CHIP Act’’. 
SEC. 2. INCREASING OVERSIGHT OF TERMINATION OF MED-
ICAID PROVIDERS. 
(a) INCREASED OVERSIGHT AND REPORTING.— 
(1) STATE REPORTING REQUIREMENTS.—Section 
1902(kk) of the Social Security Act (42 U.S.C. 
1396a(kk)) is amended— 
(A) by redesignating paragraph (8) as 
paragraph (9); and 
(B) by inserting after paragraph (7) the fol-
lowing new paragraph: 
‘‘(8) PROVIDER TERMINATIONS.— 
‘‘(A) IN GENERAL.—Beginning on January 
1, 2017, in the case of a notification under sub-
section (a)(41) with respect to a termination for 
a reason specified in section 455.101 of title 42, 
Code of Federal Regulations (as in effect on No-
vember 1, 2015) or for any other reason specified 
by the Secretary, of the participation of a pro-
vider of services or any other person under the 
State plan, the State, not later than 21 business 
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days after the effective date of such termination, 
submits to the Secretary with respect to any such 
provider or person, as appropriate— 
‘‘(i) the name of such provider or per-
son; 
‘‘(ii) the provider type of such provider 
or person; 
‘‘(iii) the specialty of such provider’s 
or person’s practice; 
‘‘(iv) the date of birth, Social Security 
number, national provider identifier, Fed-
eral taxpayer identification number, and 
the State license or certification number of 
such provider or person; 
‘‘(v) the reason for the termination; 
‘‘(vi) a copy of the notice of termi-
nation sent to the provider or person; 
‘‘(vii) the effective date of such termi-
nation specified in such notice; and 
‘‘(viii) any other information required 
by the Secretary. 
‘‘(B) EFFECTIVE DATE DEFINED.—For pur-
poses of this paragraph, the term ‘effective date’ 
means, with respect to a termination described 
in subparagraph (A), the later of— 
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‘‘(i) the date on which such termi-
nation is effective, as specified in the notice 
of such termination; or 
‘‘(ii) the date on which all appeal 
rights applicable to such termination have 
been exhausted or the timeline for any such 
appeal has expired.’’. 
(2) REPORTING REQUIREMENTS FOR MANAGED 
CARE ENTITIES.—Section 1932(d) of the Social Secu-
rity Act (42 U.S.C. 1396u–2(d)) is amended by add-
ing at the end the following new paragraph: 
‘‘(5) STATE
REPORTING
REQUIREMENTS
FOR 
MANAGED CARE ENTITIES.— 
‘‘(A) IN
GENERAL.—With respect to any 
contract with a managed care entity under sec-
tion 1903(m) or 1905(t)(3) (as applicable), be-
ginning on the later of the first day of the first 
plan year for such managed care entity that be-
gins after the date of the enactment of this para-
graph or January 1, 2017, the State shall re-
quire that such contract include a provision that 
providers of services or persons terminated (as 
described in section 1902(kk)(8)) from participa-
tion under this title, title XVIII, or title XXI be 
terminated from participating under this title as 
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a provider in any network of such entity that 
serves individuals eligible to receive medical as-
sistance under this title. 
‘‘(B) NOTIFICATION OF TERMINATION.—For 
the period beginning on January 1, 2017, and 
ending on the date on which the enrollment of 
providers under paragraph (6) is complete for a 
State, the State shall provide for a system for 
notifying managed care entities (as defined in 
subsection (a)(1)) of the termination (as de-
scribed in section 1902(kk)(8)) of providers of 
services or persons from participation under this 
title, title XVIII, or title XXI.’’. 
(3) TERMINATION
NOTIFICATION
DATABASE.— 
Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended by adding at the end the following 
new subsection: 
‘‘(ll) TERMINATION NOTIFICATION DATABASE.—In the 
case of a provider of services or any other person whose 
participation under this title, title XVIII, or title XXI is 
terminated (as described in subsection (kk)(8)), the Sec-
retary shall, not later than 21 business days after the date 
on which the Secretary terminates such participation under 
title XVIII or is notified of such termination under sub-
section (a)(41) (as applicable), review such termination 
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