Medicaid Improvement and State Flexibility Act of 2025This bill authorizes states to approve their own experimental, pilot, or demonstration project under Medicaid if the project provides certain benefits involving electronic benefits transfer (EBT) cards. (Currently, the Centers for Medicare & Medicaid Services approves Medicaid demonstration projects; such projects are also known as Section 1115 Demonstrations.)Specifically, the project must provide enrollees who elect to participate with an EBT card to purchase primary care services; enrollees must receive any remaining balance at the end of the year in the form of a cash payment and must also obtain catastrophic health insurance.
HIV medications; prohibit health plans and Medicaid from subjecting to protocols that restrict dispensing of.
HIV medications; prohibit health plans and Medicaid from subjecting to protocols that restrict dispensing of.
Kids' Access to Primary Care Act of 2025This bill modifies payments for Medicaid primary care services. Specifically, the bill applies a Medicare payment rate floor to Medicaid primary care services that are provided after the date of enactment of the bill and extends the payment rate to additional types of practitioners (e.g., obstetricians).The Centers for Medicare & Medicaid Services must conduct a study on the number of children enrolled in Medicaid, the number of providers receiving payment for primary care services, and associated payment rates before and after the bill's implementation.
Medicaid Third Party Liability Act This bill modifies requirements relating to Medicaid third-party liability. Current law generally requires legally liable third parties (e.g., health insurers) to pay claims before Medicaid. However, Medicaid must pay first (and seek reimbursement from liable third parties) for claims for (1) preventive pediatric care, and (2) services for an individual for whom child support enforcement is being conducted by the state. The bill repeals these exceptions. Current law also requires state Medicaid programs to take all reasonable measures to identify legally liable third parties. The bill specifically prohibits federal Medicaid payment for services to individuals for whom third-party insurance information was not obtained and verified by the state.
To Modify Payment Of Benefits For Certain Healthcare Providers Under A Health Benefit Plan.
Advancing Enrollment and Reducing Drug Costs ActThis bill specifies that certain Medicaid enrollees automatically qualify for low-income subsidies under the Medicare prescription drug benefit. Specifically, the bill automatically qualifies individuals who were enrolled in Medicaid before they turned 65 (as part of Medicaid expansion under the Patient Protection and Affordable Care Act) and whose income is below 200% of the federal poverty line.
SNAP and Medicaid benefits; confirm status as eligible alien under federal law to be eligible for.
Cover Outstanding Vulnerable Expansion-eligible Residents Now Act or the COVER Now Act This bill establishes a demonstration program to allow local governments to provide health benefits to the Medicaid expansion population in states that have not expanded Medicaid. Under the program, local governments may provide coverage for individuals who are newly eligible for Medicaid under the Patient Protection and Affordable Care Act (i.e., the Medicaid expansion population) for a maximum of 10 years, or until their respective states expand Medicaid. The bill provides a 100% federal matching rate for the first three years of program participation. The bill prohibits states from taking certain actions against participating localities, such as withholding funding, increasing taxes, or restricting provider participation. States that violate these requirements are subject to certain funding penalties.
Requires Medicaid provide health benefits coverage, and places certain requirements on insurers and State Health Benefits Program regarding existing mandate on health benefits coverage, for certain over-the-counter contraceptives.