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S. 1787

Medicaid Managed Care Responsibility and Equity Act

Medicaid Managed Care Responsibility and Equity Act - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act (SSA) with respect to managed care requirements.

Requires a minimum medical loss ratio of at least 85% for Medicaid and CHIP managed care plans under contracts between a state and a managed medical care entity (health maintenance organization), but a minimum ratio of only 80% for an entity in which at least 10% of the enrollees are optional targeted low-income children.

Prescribes administrative penalties for failure to maintain such ratios.

Applies the same minimum medical loss ratios to a state child health (CHIP) plan, except for a medical loss ratio of at least 80% for managed care organizations.

Read twice and referred to the Committee on Finance.

Sen. Rockefeller, John D., IV [D-WV](D-WV)Sponsor
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  • Introduced in SenateDec 10, 2013
  1. IntroReferral

    Read twice and referred to the Committee on Finance.

  2. IntroReferral10000

    Introduced in Senate

Medicaid Managed Care Responsibility and Equity Act — Informed