Title: Better Accounting for Medicaid Costs Act of 2017
Policy area: Health

Summary:
Better Accounting for Medicaid Costs Act of 2017
This bill amends title XI (General Provisions) of the Social Security Act to require the Centers for Medicare & Medicaid Services (CMS) to follow rulemaking procedures with respect to certain Medicaid subregulatory policies.
Before issuing a Medicaid subregulatory policy, CMS must determine the extent to which the policy is projected, with respect to each year in a 10-year period, to increase state or federal expenditures under the Medicaid program. If the policy is projected to increase expenditures by an amount exceeding a specified threshold, CMS may implement the policy only through notice and comment rulemaking.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 542 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 542

 To amend title XI of the Social Security Act to require the Secretary 
of Health and Human Services to follow rulemaking procedures for costly 
                    Medicaid subregulatory policies.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 13, 2017

  Mr. Collins of New York (for himself, Mr. Mullin, Mr. Guthrie, Mr. 
   Bucshon, and Mr. Flores) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XI of the Social Security Act to require the Secretary 
of Health and Human Services to follow rulemaking procedures for costly 
                    Medicaid subregulatory policies.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Better Accounting for Medicaid Costs 
Act of 2017''.

SEC. 2. REQUIRING RULEMAKING FOR COSTLY MEDICAID SUBREGULATORY 
              POLICIES.

    (a) In General.--Section 1102 of the Social Security Act (42 U.S.C. 
1302) is amended by adding at the end the following new subsection:
    ``(c) Medicaid Subregulatory Policies.--
            ``(1) Effect on annual government expenditures.--Before any 
        Medicaid subregulatory policy (as defined in paragraph (4)) may 
        be issued, the Secretary shall determine the extent to which 
        such policy, with respect to each year in the 10-year period 
        beginning on the proposed effective date for such policy, is 
        projected to result in--
                    ``(A) an increase in total estimated expenditures 
                by States under title XIX for such year, as compared to 
                the estimated expenditures by States under such title 
                for such year if such policy were not issued; or
                    ``(B) an increase in the estimated expenditures by 
                the Federal Government under such title for such year, 
                as compared to the estimated expenditures by the 
                Federal Government under such title for such year if 
                such policy were not issued.
            ``(2) Rulemaking for certain costly policies.--If the 
        Secretary determines under paragraph (1) that a Medicaid 
        subregulatory policy, with respect to any year for which such 
        determination is made, is projected to result in--
                    ``(A) an increase described in subparagraph (A) of 
                such paragraph of at least $50,000,000; or
                    ``(B) an increase described in subparagraph (B) of 
                such paragraph of at least $100,000,000;
        the Secretary may implement such policy only through notice and 
        comment rulemaking under section 553 of title 5, United States 
        Code.
            ``(3) Inclusion of estimated expenditures in issuance of 
        subregulatory policies.--If the Secretary issues a Medicaid 
        subregulatory policy other than through rulemaking, the 
        Secretary shall include in such issuance a specification of the 
        estimated expenditures determined under subparagraphs (A) and 
        (B) of paragraph (1) with respect to such policy.
            ``(4) Medicaid subregulatory policy defined.--
                    ``(A) In general.--In this subsection, the term 
                `Medicaid subregulatory policy' means, subject to 
                subparagraph (B), any written guidance, or other 
                written statement of policy, issued at the discretion 
                of any official of the Department of Health and Human 
                Services with respect to the Medicaid program under 
                title XIX, including a statement of policy in the form 
                of a letter to State Medicaid directors, an 
                Informational Bulletin, and Frequently Asked Questions.
                    ``(B) Exception.--Such term does not include any 
                guidance or other statement of policy that relates to 
                the management or personnel of the Department of Health 
                and Human Services.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to policies issued on or after the date of the 
enactment of this Act.
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