SB 220 — AN ACT TO AMEND TITLE 18 RELATING TO HEALTH INSURANCE FOR CHILDREN AND PERSONS ON MEDICAID.
Last action — Signed by Governor
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✓Introduced
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✓In Committee
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✓Passed Senate
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✓Passed House
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced February 29, 2024. Enacted.
Prognosis
Where this bill stands today.
Odds of enactment
HighHow often bills like it became law.
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Enacted
Current position in the legislative process.
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8 sponsors
8 primary, 0 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (5 D).
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Cleared a recorded vote
Passed 2 recorded votes so far.
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
Summary
Medicaid is generally the “payer of last resort,” meaning that Medicaid only pays claims for covered items and services if there are no other liable third-party payers for the same items and services. When Medicaid beneficiaries have one or more additional sources of coverage for health care services, third-party liability (TPL) rules govern the legal obligation of such third parties. Section 1902(a)(25)(A) of the Social Security Act defines third-party payers as health insurers, managed care organizations, and group health plans, among others. The federal Consolidated Appropriations Act of 2022 (CAA 2022), enacted March 15, 2022, increased state flexibility with respect to TPL. Section 202 of the CAA, 2022 amended section 1902(a)(25)(I) of the Act to require a state plan for medical assistance to provide assurances satisfactory to the Secretary that the state has state laws in place that bar responsible third-party payers (other than Medicare plans) from refusing payment for an item or service solely on the basis that such item or service did not receive prior authorization under the third-party payer’s rules. Specifically, if the responsible third party requires prior authorization for an item or service furnished to a Medicaid-eligible individual, the responsible third party must accept the authorization provided by the state that the item or service is covered under the state plan (or waiver of such plan) for such individual, as if such authorization was made by the third party for such item or service. Authorization by the state means that the item or service an individual received (and for which third-party reimbursement is being sought) is a covered service or item under the Medicaid state plan (or waiver of such plan) for that individual. The effective date for this new federal provision is January 1, 2024, with an exception for states that first need to pass state legislation to comply with the change in law. This bill is intended to update the provisions of Title 18, § 4003 to make them consistent with federal law contained in the Consolidated Appropriations Act of 2022.
Bill Text
- Bill Text View text Current pdf
Action History
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Signed by Governor
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Passed By House. Votes: 39 YES 2 ABSENT
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Reported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 3 Favorable, 6 On Its Merits
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Assigned to Economic Development/Banking/Insurance & Commerce Committee in House
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Passed By Senate. Votes: 21 YES
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Reported Out of Committee (Health & Social Services) in Senate with 3 Favorable, 2 On Its Merits
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Introduced and Assigned to Health & Social Services Committee in Senate
Sponsors
- Eric Morrison · Primary
- Laura V. Sturgeon · Primary
- Marie Pinkney · Primary
- Kendra Johnson · Primary
- Kerri Evelyn Harris · Primary
- Sarah McBride · Primary
- Sherry Dorsey Walker · Primary
- Peter C. Schwartzkopf · Primary
Sponsorship breakdown
Export CSV (upgrade) →8 sponsors · 0 co-sponsors · 54 not signed on
Sponsors (8)
- Eric Morrison Democratic
- Laura V. Sturgeon Democratic
- Marie Pinkney Democratic
- Kendra Johnson Democratic
- Kerri Evelyn Harris Democratic
- Sarah McBride
- Sherry Dorsey Walker
- Peter C. Schwartzkopf
Co-sponsors (0)
None.
Not signed on (54)
54 members have not signed on to this bill.
Show all 54 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 6 | 0 | 0 | 1 |
| Democratic | 19 | 0 | 0 | 1 |
| Republican | 14 | 0 | 0 | 0 |
| Total | 39 | 0 | 0 | 2 |
| % of votes cast | 95% | 0% | 0% | 5% |
How each member voted (41)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 13 | 0 | 0 | 0 |
| Republican | 6 | 0 | 0 | 0 |
| Unaffiliated | 2 | 0 | 0 | 0 |
| Total | 21 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (21)
| Member | Party | Vote |
|---|---|---|
| Kyle Evans Gay | — | Yea |
| Sarah McBride | — | Yea |
| Bryan Townsend | Democratic | Yea |
| Darius J. Brown | Democratic | Yea |
| David P. Sokola | Democratic | Yea |
| John "Jack" Walsh | Democratic | Yea |
| Kyra L. Hoffner | Democratic | Yea |
| Laura V. Sturgeon | Democratic | Yea |
| Marie Pinkney | Democratic | Yea |
| Nicole Poore | Democratic | Yea |
| Russell Huxtable | Democratic | Yea |
| S. Elizabeth Lockman | Democratic | Yea |
| Spiros Mantzavinos | Democratic | Yea |
| Stephanie L. Hansen | Democratic | Yea |
| Trey Paradee | Democratic | Yea |
| Brian Pettyjohn | Republican | Yea |
| Bryant L. Richardson | Republican | Yea |
| Dave G. Lawson | Republican | Yea |
| David L. Wilson | Republican | Yea |
| Eric Buckson | Republican | Yea |
| Gerald W. Hocker | Republican | Yea |
Subjects
Frequently asked questions
- What does SB 220 do?
- Medicaid is generally the “payer of last resort,” meaning that Medicaid only pays claims for covered items and services if there are no other liable third-party payers for the same items and services. When Medicaid beneficiaries have one or more additional sources of coverage for health care services, third-party liability (TPL) rules govern the legal obligation of such third parties. Section 1902(a)(25)(A) of the Social Security Act defines third-party payers as health insurers, managed care organizations, and group health plans, among others. The federal Consolidated Appropriations Act of 2022 (CAA 2022), enacted March 15, 2022, increased state flexibility with respect to TPL. Section 202 of the CAA, 2022 amended section 1902(a)(25)(I) of the Act to require a state plan for medical assistance to provide assurances satisfactory to the Secretary that the state has state laws in place that bar responsible third-party payers (other than Medicare plans) from refusing payment for an item or service solely on the basis that such item or service did not receive prior authorization under the third-party payer’s rules. Specifically, if the responsible third party requires prior authorization for an item or service furnished to a Medicaid-eligible individual, the responsible third party must accept the authorization provided by the state that the item or service is covered under the state plan (or waiver of such plan) for such individual, as if such authorization was made by the third party for such item or service. Authorization by the state means that the item or service an individual received (and for which third-party reimbursement is being sought) is a covered service or item under the Medicaid state plan (or waiver of such plan) for that individual. The effective date for this new federal provision is January 1, 2024, with an exception for states that first need to pass state legislation to comply with the change in law. This bill is intended to update the provisions of Title 18, § 4003 to make them consistent with federal law contained in the Consolidated Appropriations Act of 2022.
- Who sponsors SB 220?
- SB 220 is sponsored by Eric Morrison (Democratic), Laura V. Sturgeon (Democratic), Marie Pinkney (Democratic), Kendra Johnson (Democratic), Kerri Evelyn Harris (Democratic), Sarah McBride, Sherry Dorsey Walker, and Peter C. Schwartzkopf.
- What is the current status of SB 220?
- This bill has been enacted into law. Introduced February 29, 2024. Enacted.
- Where can I track SB 220?
- Track SB 220 free on One Click Politics — get push/email alerts when it moves.
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