Better Accounting for Medicaid Costs Act of 2017

“(c) Medicaid subregulatory policies

“(1) Effect on annual government expenditures—Before any Medicaid subregulatory policy (as defined in paragraph (4)) may be issued, the Secretary shall determine the extent to which such policy, with respect to each year in the 10-year period beginning on the proposed effective date for such policy, is projected to result in—

“(A) an increase in total estimated expenditures by States under title XIX for such year, as compared to the estimated expenditures by States under such title for such year if such policy were not issued; or

“(B) an increase in the estimated expenditures by the Federal Government under such title for such year, as compared to the estimated expenditures by the Federal Government under such title for such year if such policy were not issued.

“(2) Rulemaking for certain costly policies—If the Secretary determines under paragraph (1) that a Medicaid subregulatory policy, with respect to any year for which such determination is made, is projected to result in—

“(A) an increase described in subparagraph (A) of such paragraph of at least $50,000,000; or

“(B) an increase described in subparagraph (B) of such paragraph of at least $100,000,000;

“(3) Inclusion of estimated expenditures in issuance of subregulatory policies—If the Secretary issues a Medicaid subregulatory policy other than through rulemaking, the Secretary shall include in such issuance a specification of the estimated expenditures determined under subparagraphs (A) and (B) of paragraph (1) with respect to such policy.

“(4) Medicaid subregulatory policy defined

“(A) In general—In this subsection, the term Medicaid subregulatory policy means, subject to subparagraph (B), any written guidance, or other written statement of policy, issued at the discretion of any official of the Department of Health and Human Services with respect to the Medicaid program under title XIX, including a statement of policy in the form of a letter to State Medicaid directors, an Informational Bulletin, and Frequently Asked Questions.

“(B) Exception—Such term does not include any guidance or other statement of policy that relates to the management or personnel of the Department of Health and Human Services.”