legislation: 101-hr-5565

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bill_id congress bill_type bill_number title policy_area introduced_date latest_action_date latest_action_text origin_chamber sponsor_name sponsor_state sponsor_party sponsor_bioguide_id cosponsor_count summary_text update_date url
101-hr-5565 101 hr 5565 Medicaid Physician Service Quality Improvement Act of 1990 Health 1990-09-10 1990-09-28 Referred to the Subcommittee on Health and the Environment. House Rep. Weiss, Ted [D-NY-17] NY D W000258 5 Medicaid Physician Service Quality Improvement Act of 1990 - Directs the Secretary of Health and Human Services to establish a system for providing Medicaid (title XIX of the Social Security Act) physicians with unique identifying numbers. Amends the Medicaid program to require such numbers to be included in the claim for physician services in order for the claim to be paid. Requires contracts between States and any entity for the provision of hospital services to provide maintenance of sufficient patient encounter data to identify the physician who delivers services to patients in order for States to be reimbursed by the Federal Government. Requires State plans for medical assistance to maintain updated lists of all physicians who are certified to participate. Requires foreign medical graduates to pass the Foreign Medical Graduate Examination required for participation in the Medicare program (title XVIII of the Social Security Act) in order to be issued a unique identifying number. Amends the Medicaid program to establish minimum qualifications for billing for physician services to children and pregnant women, including: (1) certification in pediatrics and obstetrics; (2) affiliation with a hospital participating in Medicaid; or (3) having a consultation arrangement with a physician who is certified in such specialties. Requires hospitals which receive extra Medicare payments by reason of their serving a disproportionate share of low-income patients to extend admitting privileges to Medicaid physicians. Requires State plans for medical assistance to provide for: (1) quality of care reviews of high-volume physicians; and (2) the reporting of any negative action or finding regarding a health care practitioner or facility by any State licensing authority, peer review organization, or private accreditation entity. 2025-08-26T17:25:54Z  

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