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H.R. 7217 (115th): IMPROVE Act

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Dec 6, 2018.

Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act or the IMPROVE Act

This bill establishes a state Medicaid option to provide for medical assistance with respect to coordinated care provided through a health home (i.e., a designated provider or team of health-care professionals) for children with medically complex conditions. States must determine payment methodologies in accordance with specified requirements; payments also temporarily qualify for an enhanced federal matching rate.

The bill also makes a series of reductions relating to federal Medicaid expenditures. Among other changes, the bill reduces the federal matching rate for states that do not have required asset-verification programs for determining Medicaid eligibility.

Further, drug manufacturers with Medicaid rebate agreements for covered outpatient drugs must disclose drug product information. Manufacturers are subject to civil penalties for knowingly misclassifying drugs. Manufacturers are also required to compensate for rebates that were initially underpaid as a result of misclassification (whether or not such misclassification was committed knowingly).

Finally, the bill excludes specified wheelchairs and associated accessories from Medicare's competitive acquisition program (in which rates are set through a competitive bidding program rather than by an established fee schedule).