Payment reduction related to certain erroneous excess payments under Medicaid

(a) In general Section 1903(u)(1) of the Social Security Act (42 U.S.C. 1396b(u)(1)) is amended— (1) in subparagraph (A)— (A) by inserting for audits conducted by the Secretary, or, at the option of the Secretary, audits conducted by the State after exceeds 0.03; and (B) by inserting, to the extent practicable before the period at the end; (2) in subparagraph (B)— (A) by striking The Secretary and inserting (i) Subject to clause (ii), the Secretary; and (B) by adding at the end the following new clause: (ii) The amount waived under clause (i) for a fiscal year may not exceed an amount equal to the erroneous excess payments for medical assistance described in subparagraph (D)(i)(II) made for such fiscal year that exceed the allowable error rate of 0.03.. (3) in subparagraph (C), by striking he in each place it appears and inserting the Secretary in each such place; and (4) in subparagraph (D)(i)— (A) in subclause (I), by striking and at the end; (B) in subclause (II), by striking the period at the end and inserting, or payments where insufficient information is available to confirm eligibility, and; and (C) by adding at the end the following new subclause: (III) payments (other than payments described in subclause (I)) for items and services furnished to an individual who is not eligible for medical assistance under the State plan (or a waiver of such plan) with respect to such items and services, or payments where insufficient information is available to confirm eligibility.. (b) Effective date The amendments made by subsection (a) shall apply beginning with respect to fiscal year 2030.

(a) In general Section 1903(u)(1) of the Social Security Act (42 U.S.C. 1396b(u)(1)) is amended— (1) in subparagraph (A)— (A) by inserting for audits conducted by the Secretary, or, at the option of the Secretary, audits conducted by the State after exceeds 0.03; and (B) by inserting, to the extent practicable before the period at the end; (2) in subparagraph (B)— (A) by striking The Secretary and inserting (i) Subject to clause (ii), the Secretary; and (B) by adding at the end the following new clause: (ii) The amount waived under clause (i) for a fiscal year may not exceed an amount equal to the erroneous excess payments for medical assistance described in subparagraph (D)(i)(II) made for such fiscal year that exceed the allowable error rate of 0.03.. (3) in subparagraph (C), by striking he in each place it appears and inserting the Secretary in each such place; and (4) in subparagraph (D)(i)— (A) in subclause (I), by striking and at the end; (B) in subclause (II), by striking the period at the end and inserting, or payments where insufficient information is available to confirm eligibility, and; and (C) by adding at the end the following new subclause: (III) payments (other than payments described in subclause (I)) for items and services furnished to an individual who is not eligible for medical assistance under the State plan (or a waiver of such plan) with respect to such items and services, or payments where insufficient information is available to confirm eligibility.. (b) Effective date The amendments made by subsection (a) shall apply beginning with respect to fiscal year 2030.