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HD 3404

An Act to protect qualified medicare beneficiaries from improper billing

194th Legislature (2025-2026) Introduced by Steve Ultrino

Bill protects low-income Medicare beneficiaries from improper billing by prohibiting providers from charging costs Medicaid must cover, with enforcement mechanisms for violations.

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WeVote Research Nonpartisan
Bill Summary · HD 3404

Legislative bill overview

HD 3404 aims to protect Medicare beneficiaries who qualify for Medicaid assistance (Qualified Medicare Beneficiaries or QMBs) from improper billing practices by healthcare providers. The bill establishes protections ensuring providers cannot bill QMBs for costs that Medicaid is obligated to cover, and creates enforcement mechanisms for violations.

Why is this important

QMBs are among the most vulnerable Medicare populations—elderly and disabled individuals with low incomes who rely on both programs. Improper billing directly reduces their access to care and increases out-of-pocket costs. Without explicit protections, providers may attempt to shift costs onto beneficiaries, circumventing the safety net these dual programs provide.

Potential points of contention

  • Provider compliance costs: Healthcare facilities may argue the bill creates administrative burdens and compliance expenses, potentially affecting rural or smaller providers more severely
  • Medicaid reimbursement rates: If Medicaid rates are below cost, providers might resist enforcement, claiming they cannot absorb losses while serving this population
  • Enforcement clarity: The bill's specific enforcement mechanisms, penalties, and oversight authority may need definition—unclear enforcement could limit effectiveness or create inconsistent application

Compiled from official sources — confirm details with the bill’s official record.

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