been 
made 
under 
the 
respective 
State’s plan (or under a waiver of the 
plan); and 
‘‘(II) after January 1, 2023, as a 
valid authorization of the responsible 
third party for the furnishing of an 
item or service to an individual eligi-
ble to receive medical assistance under 
this title, an authorization made on 
behalf of such individual under the 
State plan (or under a waiver of such 
plan) for the furnishing of such item 
or service to such individual;’’; 
(3) in clause (iii)— 
(A) by inserting ‘‘not later than 60 days 
after receiving’’ before ‘‘respond to’’; 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,’’. 
(d) 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-
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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 third 
party (as described in such paragraph) and the plan 
of such insurer in which the individual is enrolled’’ 
after ‘‘sufficient information’’. 
(2) FFP UNAVAILABLE WITHOUT INSURANCE 
STATUS VERIFICATION.—Section 1903(i) of the So-
cial Security Act (42 U.S.C. 1396b(i)) is amended— 
(A) in paragraph (26), by striking ‘‘; or’’ 
and inserting ‘‘;’’; 
(B) in paragraph (27), by striking ‘‘of the 
State.’’ and inserting ‘‘of the State; or’’; and 
(C) by inserting after paragraph (27) the 
following: 
‘‘(28) with respect to any amounts after Janu-
ary 1, 2023, expended for medical assistance for in-
dividuals for whom the State has not obtained and 
verified, 
in 
accordance 
with 
section 
1902(a)(25)(A)(i), information on whether such an 
individual has coverage provided through a third 
party (as described in such paragraph) and the plan 
of such coverage in which the individual is en-
rolled.’’. 
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SEC. 3. EFFECTIVE DATE. 
In the case of a State plan for medical assistance 
under title XIX of the Social Security Act that the Sec-
retary of Health and Human Services determines requires 
State legislation (other than legislation appropriating 
funds) in order for the plan to meet the additional require-
ment imposed by the amendments made under this sec-
tion, the State plan shall not be regarded as failing to 
comply with the requirements of such title solely on the 
basis of its failure to meet this additional requirement be-
fore the first day of the first calendar quarter beginning 
after the close of the first regular session of the State leg-
islature that begins after the date of the enactment of this 
Act. For purposes of the previous sentence, in the case 
of a State that has a 2-year legislative session, each year 
of such session shall be deemed to be a separate regular 
session of the State legislature. 
Æ 
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