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Consolidated Appropriations Act, 2026Section 6106 › Proposal

A State may not claw back payments consistent with the old rule

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6106, Sec. 6106. Written by .

A State may not claw back payments consistent with the old rule

The document says “shall notWho acts: StatesHow: statuteSec. 6106 in the PDF
What the document says

“A State shall not recoup any payment adjustment made by the State to a hospital for a Medicaid State plan rate year described in subparagraph (A) if such payment adjustment is consistent with section 1923(g) of such Act (42 U.S.C. 1396r-4(g)) as in effect on October 1, 2021.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6106

Subparagraph (B) bars a State from recouping a payment adjustment made to a hospital for one of those prior rate years, if the adjustment was consistent with section 1923(g) of the Social Security Act as in effect on October 1, 2021.

What the document actually says

“A State shall not recoup any payment adjustment made by the State to a hospital for a Medicaid State plan rate year described in subparagraph (A) if such payment adjustment is consistent with section 1923(g) of such Act (42 U.S.C. 1396r-4(g)) as in effect on October 1, 2021.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6106
That sentence, in plain words

A state may not take back money it paid a hospital for one of those years. That holds if the payment fit the rule as it stood on October 1, 2021.

What this is about

To recoup is to take money back after paying it. A hospital that followed the old rule keeps what it got.

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