‘‘(II) as a valid authorization of 
the responsible third party for the fur-
nishing of an item or service to an in-
dividual eligible to receive medical as-
sistance under this title, an authoriza-
tion made on behalf of such individual 
under the State plan (or under a 
waiver of such plan) for the fur-
nishing of such item or service to such 
individual;’’; 
(3) in clause (iii)— 
(A) by striking ‘‘respond to’’ and inserting 
‘‘not later than 60 days after receiving’’; and 
(B) by striking ‘‘; and’’ at the end and in-
serting ‘‘, respond to such inquiry; and’’; and 
(4) in clause (iv), by inserting ‘‘a failure to ob-
tain a prior authorization,’’ after ‘‘claim form,’’. 
(e) STATE INCENTIVE TO PURSUE THIRD PARTY LI-
ABILITY FOR NEWLY ELIGIBLES.—Section 1903(d)(2)(B) 
of the Social Security Act (42 U.S.C. 1396b(d)(2)(B)), as 
amended by subsection (c)(2), is amended by adding at 
the end the following: ‘‘In the case of expenditures for 
medical assistance provided during 2017 and subsequent 
years for individuals described in subclause (VIII) of sec-
tion 1902(a)(10)(A)(i), in determining the amount, if any, 
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of overpayment under this subparagraph with respect to 
such medical assistance, the Secretary shall apply the Fed-
eral medical assistance percentage for the State under sec-
tion 1905(b), notwithstanding the application of section 
1905(y).’’. 
SEC. 3. COMPLIANCE WITH THIRD PARTY INSURANCE RE-
PORTING. 
(a) IN GENERAL.—Section 1903 of the Social Secu-
rity Act (42 U.S.C. 1396b) is amended by inserting after 
subsection (m) the following new subsection: 
‘‘(n)(1) For any year beginning after 2020 (except 
as provided in paragraph (2)), unless a State complies 
with the requirements of section 1902(a)(25) with respect 
to each calendar quarter in such year, the Federal medical 
assistance percentage shall be reduced by 1 percentage 
point for calendar quarters in each subsequent year in 
which the State fails to so comply (and cumulatively for 
a failure to so comply for a period of consecutive years). 
‘‘(2) Notwithstanding paragraph (1), the reduction in 
the Federal medical assistance percentage shall apply— 
‘‘(A) in the case of a failure of the State to 
comply with the requirements of section 1902(a)(25) 
with respect to payment for items and services fur-
nished to individuals described in subclause (VIII) of 
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section 1902(a)(10)(A)(i), for any year beginning 
after 2018; and 
‘‘(B) in the case of a failure of the State to 
comply with the requirements of section 1902(a)(25) 
with respect to payment for items and services fur-
nished to individuals described in subdivision (i), 
(iii), or (iv) of section 1905(a), for any year begin-
ning after 2019.’’. 
(b) VERIFICATION
OF
INSURANCE
STATUS
RE-
QUIRED.— 
(1) IN GENERAL.—Section 1902(a)(25)(A)(i) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(25)(A)(i)) is amended by inserting ‘‘, in-
cluding the collection of, with respect to an indi-
vidual seeking to receive medical assistance under 
this title, information on whether the individual has 
health insurance coverage provided through a health 
insurer (as described in section 1902(nn)) and the 
plan of such insurer in which the individual is en-
rolled’’ after ‘‘sufficient information’’. 
(2) FFP UNAVAILABLE WITHOUT INSURANCE 
STATUS VERIFICATION.—Section 1903(i)(25) of the 
Social Security Act (42 U.S.C. 1396b(i)(25)) is 
amended— 
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(A) by striking ‘‘with respect to’’ and in-
serting ‘‘(A) with respect to’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘and (B) with respect to 
any amounts expended for medical assistance 
for individuals for whom the State has not ob-
tained and verified, in accordance with section 
1902(a)(25)(A)(i), information on whether such 
an individual has health insurance coverage 
provided through a health insurer (as described 
in section 1902(nn)) and the plan of such in-
surer in which the individual is enrolled’’. 
SEC. 4. APPLICATION TO CHIP. 
(a) IN GENERAL.—Section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)) is amended— 
(1) 
by 
redesignating 
subparagraphs 
(B) 
through (R) as subparagraphs (C) through (S), re-
spectively; and 
(2) by inserting after subparagraph (A) the fol-
lowing new subparagraph: 
‘‘(B) Section 1902(a)(25) (relating to third 
party liability).’’. 
(b) 
MANDATORY
REPORTING.—Section 
1902(a)(25)(I)(i) of the Social Security Act (42 U.S.C. 
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1396a(a)(25)(I)(i)), as amended by section 1(d), is further 
amended— 
(1) by striking ‘‘(and, at State option, child’’ 
and inserting ‘‘and child’’; and 
(2) by striking ‘‘title XXI)’’ and inserting ‘‘title 
XXI’’. 
SEC. 5. TRAINING ON THIRD PARTY LIABILITY. 
Section 1936 of the Social Security Act (42 U.S.C. 
1396u–6) is amended— 
(1) in subsection (b)(4), by striking ‘‘and qual-
ity of care’’ and inserting ‘‘, quality of care, and the 
liability of responsible third parties (as defined in 
section 1902(nn))’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(f) THIRD PARTY LIABILITY TRAINING.—With re-
spect to education or training activities carried out pursu-
ant to subsection (b)(4) with respect to the liability of re-
sponsible third parties (as defined in section 1902(nn) for 
payment for items and services furnished under State 
plans (or under waivers of such plans)) under this title, 
the Secretary shall— 
‘‘(1) publish (and update on an annual basis) 
on the public Internet website of the Centers for 
Medicare & Medicaid Services a dedicated Internet 
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