I 
117TH CONGRESS 
2D SESSION 
H. R. 6622 
To amend title XIX of the Social Security Act to provide clarification with 
respect to the liability of third party payers for medical assistance paid 
under the Medicaid program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 7, 2022 
Mr. BURGESS introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to provide 
clarification with respect to the liability of third party 
payers for medical assistance paid under the Medicaid 
program, and for other purposes. 
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 ‘‘Medicaid Third Party 
Liability Act’’. 
SEC. 2. MEDICAID THIRD PARTY LIABILITY. 
(a) REMOVAL OF SPECIAL TREATMENT OF CERTAIN 
TYPES
OF CARE
AND PAYMENTS UNDER MEDICAID 
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THIRD PARTY LIABILITY RULES.—Section 1902(a)(25) 
of the Social Security Act (42 U.S.C. 1396a(a)(25)) is 
amended by striking subparagraphs (E) and (F) and re-
designating the subsequent subparagraphs accordingly. 
(b) CLARIFICATION OF ROLE OF HEALTH INSURERS 
WITH RESPECT TO THIRD PARTY LIABILITY.—Section 
1902(a)(25) of the Social Security Act (42 U.S.C. 
1396a(a)(25)), as amended by subsection (b)— 
(1) in subparagraph (F), by striking at the end 
‘‘and’’; 
(2) in subparagraph (G), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(H) that, in the case of a State after Jan-
uary 1, 2023, that provides medical assistance 
under this title through a contract with a health 
insurer (including a group health plan, as de-
fined in section 607(1) of the Employee Retire-
ment Income Security Act of 1974, a self-in-
sured plan, a fully insured plan, a service ben-
efit plan, a managed care organization, a phar-
macy benefit manager, and any other health 
plan determined appropriate by the Sec-
retary)— 
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‘‘(i) such contract shall specify— 
‘‘(I) whether the State is dele-
gating to such insurer all or some of 
its right of recovery from a respon-
sible third party for an item or service 
for which payment has been made 
under the State plan (or under a 
waiver of the plan); and 
‘‘(II) whether the State is trans-
ferring to such insurer all or some of 
the assignment to the State of any 
right of an individual or other entity 
to payment from a responsible third 
party for an item or service for which 
payment has been made under the 
State plan (or under a waiver of the 
plan); and 
‘‘(ii) in the case of a State that elects 
an option described in subclause (I) or (I) 
of clause (i) with respect to a health in-
surer (including a group health plan, as 
defined in section 607(1) of the Employee 
Retirement Income Security Act of 1974, a 
self-insured plan, a fully insured plan, a 
service benefit plan, a managed care orga-
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nization, a pharmacy benefit manager, and 
any other health plan determined appro-
priate by the Secretary), the State shall 
provide assurances to the Secretary that 
the State laws referred to in subparagraph 
(G) confer to the health insurer the au-
thority of the State with respect to the re-
quirements specified in clauses (i) through 
(iv) of such subparagraph.’’. 
(c) INCREASING STATE FLEXIBILITY WITH RESPECT 
TO THIRD PARTY LIABILITY.—Section 1902(a)(25)(G) of 
the Social Security Act (42 U.S.C. 1396a(a)(25)(I)), as 
redesignated by subsection (a), is amended— 
(1) in clause (i), by striking ‘‘medical assistance 
under the State plan’’ and inserting ‘‘medical assist-
ance under a State plan (or under a waiver of the 
plan)’’; 
(2) by striking clause (ii) and inserting the fol-
lowing new clause: 
‘‘(ii) accept— 
‘‘(I) the State’s right of recovery 
and the assignment to the State of 
any right of an individual or other en-
tity to payment from the party for an 
item or service for which payment has 
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