Federal Payments to Prohibited Entities

What the document says

“No Federal funds that are considered direct spending and provided to carry out a State plan under title XIX of the Social Security Act or a waiver of such a plan shall be used to make payments to a prohibited entity for items and services furnished during the 1-year period beginning on the date of the enactment of this Act”

The section bars federal funds that count as direct spending and are provided to carry out a State Medicaid plan or a waiver from being used to pay a prohibited entity for items and services given in the one year after enactment, whether paid directly or under a contract or arrangement between a State and a covered organization.

What the document says

“The term "prohibited entity" means an entity, including its affiliates, subsidiaries, successors, and clinics--”

The section defines a prohibited entity as one, with its affiliates, subsidiaries, successors and clinics, that as of the first day of the first quarter after enactment is a section 501(c)(3) organization exempt under section 501(a), is an essential community provider under section 156.235 of title 45 of the Code of Federal Regulations mainly engaged in family planning, reproductive health and related medical care, and provides abortions other than where the pregnancy resulted from rape or incest or where a physician certifies that a physical disorder, injury or illness would place the woman in danger of death unless an abortion is performed, and whose total federal and State Medicaid spending in fiscal year 2023, directly or through a covered organization or a nationwide provider network, topped $800,000. Direct spending takes its meaning from section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985, and a covered organization is a managed care entity or a prepaid inpatient or ambulatory health plan.