Medicaid Staffing Flexibility and Protection Act of 2025

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 6254 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 6254 To amend title XIX of the Social Security Act to allow States more flexibility with respect to using contractors to make eligibility determinations and redeterminations and conduct fair hearings on behalf of the State Medicaid plan, and for other purposes. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES November 21, 2025 Mr. Carter of Georgia (for himself, Mr. Davis of North Carolina, Mr. Dunn of Florida, Mr. Bacon, and Mr. Valadao) introduced the following bill; which was referred to the Committee on Energy and Commerce _______________________________________________________________________ A BILL To amend title XIX of the Social Security Act to allow States more flexibility with respect to using contractors to make eligibility determinations and redeterminations and conduct fair hearings on behalf of the State Medicaid plan, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Medicaid Staffing Flexibility and Protection Act of 2025''. SEC. 2. STATE FLEXIBILITY TO USE CONTRACTORS TO MAKE ELIGIBILITY DETERMINATIONS, REDETERMINATIONS, AND FAIR HEARINGS ON BEHALF OF A STATE. (a) Requirements With Respect to Eligibility Determinations.-- Section 1902(a)(5) of the Social Security Act (42 U.S.C. 1396a(a)(5)) is amended by inserting before the semicolon at the end the following: ``, but such determinations of eligibility may be made, at the option of a State, under a contract with another State or local agency or a contractor, so long as the contract does not provide incentives for the agency or contractor to delay eligibility determinations or to deny eligibility for individuals otherwise eligible for medical assistance