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HR 4796119th CongressIn Committee
Restoring Essential Healthcare Act
Introduced: Jul 29, 2025
Sponsor: Rep. Friedman, Laura [D-CA-30] (D-California)
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs
Restoring Essential Healthcare Act would repeal a prohibition that barred Medicaid payments to certain entities defined in Public Law 119-21. By removing Section 71113, the bill would allow Medicaid to pay for items and services provided by those prohibited entities under state Medicaid plans (or waivers) as if the prohibition had never existed. Importantly, the repeal includes retroactive payment: for services furnished during the period from the enactment of Public Law 119-21 up to the date this act becomes law, payments would be made as if the prohibition had not been in place. In short, the bill restores access to Medicaid payments for those entities and pays for past services within that window.
Key Points
- 1Repeals Section 71113 of Public Law 119-21, removing the prohibition on Medicaid payments to certain entities.
- 2Applies to items and services furnished as medical assistance under a State plan or its waivers under Title XIX (42 U.S.C. 1396 et seq.).
- 3Provides retroactive payment guidance: during the period from the enactment of Public Law 119-21 to the enactment of this section, payments should be made as if the prohibition had not existed.
- 4Payments are tied to the normal Medicaid framework (state plans and waivers), not to new program authorities.
- 5The bill relies on the definition of “prohibited entity” in subsection (b)(1) of section 71113 for who is affected, meaning the scope depends on that prior law’s definitions.
Impact Areas
Primary: Healthcare providers and entities that were previously prohibited from receiving Medicaid payments, and patients who rely on those providers for covered services under state Medicaid plans.Secondary: State Medicaid programs and administrators who implement payments to providers under Title XIX waivers and state plans; federal oversight of Medicaid finances.Additional impacts: Potential increase in Medicaid outlays due to retroactive payments; possible shifts in provider participation and access to care, depending on how states and providers utilize the restored payments. Fiscal effects would depend on the volume and value of services delivered by the affected entities during the retroactive period.
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