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senate Bill S. 1787

Medicaid Managed Care Responsibility and Equity Act

bill Progress

  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Finance
    IntroducedDecember 10th, 2013

Bill Details

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Medicaid Managed Care Responsibility and Equity Act

Official Title

A bill to require a medical loss ratio of 85 percent for Medicaid managed care plans, and for other purposes.


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.

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