This bill requires states to submit detailed reports to the federal government about "directed payments" they make through Medicaid managed care plans, starting by January 1, 2026. States must explain how these payments meet federal standards for efficiency and quality, identify which providers receive them, describe the calculation methods used to determine payment amounts, and compare the total payments to commercial insurance rates and federal payment limits. All of this information must be made publicly available on the Centers for Medicare and Medicaid Services website so patients, healthcare advocates, and the public can see how Medicaid dollars are being directed to providers. The bill affects states administering Medicaid programs and the managed care organizations and providers that receive these directed payments, but does not provide new federal funding and simply establishes a reporting requirement to increase transparency in how states allocate Medicaid resources.
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