To amend Public Law 119–21 to repeal the prohibition on making payments under the Medicaid program to certain entities.
Sponsors
Legislative Progress
IntroducedMs. Smith (for herself, Mrs. Murray, Ms. Baldwin, Ms. Duckworth, …
Summary
What This Bill Does
The Restoring Essential Healthcare Act repeals a prohibition that was enacted in Public Law 119-21 (Section 71113) that blocked Medicaid from making payments to certain healthcare providers. The bill also requires retroactive payment to these providers for medical services they already delivered to Medicaid patients during the time the prohibition was in effect.
Who Benefits and How
Healthcare providers that were classified as "prohibited entities" under the previous law directly benefit by regaining their eligibility to receive Medicaid payments. They will also receive back payments for services they provided during the prohibition period. Medicaid recipients who rely on these providers benefit by maintaining access to care without interruption. State Medicaid programs benefit by having fewer administrative restrictions on which providers they can reimburse.
Who Bears the Burden and How
Federal taxpayers bear the cost of both the ongoing restoration of payments to these entities and the retroactive payments for services already rendered during the prohibition period. The exact fiscal impact depends on the volume of services provided by these entities during the prohibition period and going forward.
Key Provisions
- Fully repeals Section 71113 of Public Law 119-21, which prohibited Medicaid payments to certain entities
- Mandates retroactive payments for all medical services provided by these entities from the date the prohibition was enacted until the date this bill becomes law
- Requires payments to be made "as if" the prohibition had never existed, ensuring no payment reductions or penalties
- Applies to all items and services furnished under State Medicaid plans or waivers under Title XIX of the Social Security Act
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Repeals a prohibition on Medicaid payments to certain entities and provides retroactive payment for services already rendered.
Policy Domains
Legislative Strategy
"Restore Medicaid funding to entities that were previously prohibited from receiving payments, with retroactive coverage"
Likely Beneficiaries
- Healthcare providers that were prohibited entities under PL 119-21
- Medicaid recipients who receive services from these entities
- State Medicaid programs
Likely Burden Bearers
- Federal taxpayers (due to retroactive payment obligations)
- Those who supported the original prohibition
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
Key Definitions
Terms defined in this bill
As defined in subsection (b)(1) of section 71113 of Public Law 119-21
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology