HR 3716 RFS 
‘‘(i) the date on which such termi-
nation is effective, as specified in the no-
tice 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) CONTRACT
REQUIREMENT
FOR
MANAGED 
CARE ENTITIES.—Section 1932(d) of the Social Se-
curity Act (42 U.S.C. 1396u–2(d)) is amended by 
adding at the end the following new paragraph: 
‘‘(5) CONTRACT REQUIREMENT FOR MANAGED 
CARE ENTITIES.—With respect to any contract with 
a managed care entity under section 1903(m) or 
1905(t)(3) (as applicable), no later than July 1, 
2018, such contract shall include a provision that 
providers of services or persons terminated (as de-
scribed in section 1902(kk)(8)) from participation 
under this title, title XVIII, or title XXI be termi-
nated from participating under this title as a pro-
vider in any network of such entity that serves indi-
viduals eligible to receive medical assistance under 
this title.’’. 
(3) TERMINATION NOTIFICATION DATABASE.— 
Section 1902 of the Social Security Act (42 U.S.C. 
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1396a) is amended by adding at the end the fol-
lowing 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 Secretary shall, not later than 21 business days after 
the date on which the Secretary terminates such participa-
tion under title XVIII or is notified of such termination 
under subsection (a)(41) (as applicable), review such ter-
mination and, if the Secretary determines appropriate, in-
clude such termination in any database or similar system 
developed pursuant to section 6401(b)(2) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 1395cc 
note; Public Law 111–148).’’. 
(4) NO FEDERAL FUNDS FOR ITEMS AND SERV-
ICES
FURNISHED
BY
TERMINATED
PROVIDERS.— 
Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended— 
(A) in subsection (i)(2)— 
(i) in subparagraph (A), by striking 
the comma at the end and inserting a 
semicolon; 
(ii) in subparagraph (B), by striking 
‘‘or’’ at the end; and 
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HR 3716 RFS 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(D) beginning not later than July 1, 
2018, under the plan by any provider of serv-
ices or person whose participation in the State 
plan is terminated (as described in section 
1902(kk)(8)) after the date that is 60 days 
after the date on which such termination is in-
cluded in the database or other system under 
section 1902(ll); or’’; and 
(B) in subsection (m), by inserting after 
paragraph (2) the following new paragraph: 
‘‘(3) No payment shall be made under this title to 
a State with respect to expenditures incurred by the State 
for payment for services provided by a managed care enti-
ty (as defined under section 1932(a)(1)) under the State 
plan under this title (or under a waiver of the plan) unless 
the State— 
‘‘(A) beginning on July 1, 2018, has a contract 
with such entity that complies with the requirement 
specified in such subparagraph; and 
‘‘(B) beginning on January 1, 2018, complies 
with 
the 
requirement 
specified 
in 
section 
1932(d)(6)(A).’’. 
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(5) DEVELOPMENT OF UNIFORM TERMINOLOGY 
FOR REASONS FOR PROVIDER TERMINATION.—Not 
later than July 1, 2017, the Secretary of Health and 
Human Services shall, in consultation with the 
heads of State agencies administering State Med-
icaid plans (or waivers of such plans), issue regula-
tions establishing uniform terminology to be used 
with respect to specifying reasons under subpara-
graph (A)(v) of paragraph (8) of section 1902(kk) 
of the Social Security Act (42 U.S.C. 1396a(kk)), as 
amended by paragraph (1), for the termination (as 
described in such paragraph) of the participation of 
certain providers in the Medicaid program under 
title XIX of such Act or the Children’s Health In-
surance Program under title XXI of such Act. 
(6) 
CONFORMING
AMENDMENT.—Section 
1902(a)(41) of the Social Security Act (42 U.S.C. 
1396a(a)(41)) is amended by striking ‘‘provide that 
whenever’’ and inserting ‘‘provide, in accordance 
with subsection (kk)(8) (as applicable), that when-
ever’’. 
(b) INCREASING AVAILABILITY OF MEDICAID PRO-
VIDER INFORMATION.— 
(1) FFS 
PROVIDER
ENROLLMENT.—Section 
1902(a) of the Social Security Act (42 U.S.C. 
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1396a(a)) is amended by inserting after paragraph 
(77) the following new paragraph: 
‘‘(78) provide that, not later than January 1, 
2017, in the case of a State plan that provides med-
ical assistance on a fee-for-service basis, the State 
shall require each provider furnishing items and 
services to individuals eligible to receive medical as-
sistance under such plan to enroll with the State 
agency and provide to the State agency the pro-
vider’s identifying information, including the name, 
specialty, date of birth, Social Security number, na-
tional provider identifier, Federal taxpayer identi-
fication number, and the State license or certifi-
cation number of the provider;’’. 
(2) MANAGED CARE PROVIDER ENROLLMENT.— 
Section 1932(d) of the Social Security Act (42 
U.S.C. 1396u–2(d)), as amended by subsection 
(a)(2), is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(6) ENROLLMENT
OF
PARTICIPATING
PRO-
VIDERS.— 
‘‘(A) IN
GENERAL.—Beginning not later 
than January 1, 2018, a State shall require 
that, in order to participate as a provider in the 
network of a managed care entity that provides 
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