# 119-hr-497: Medicaid Third Party Liability Act

119-hr-497, Medicaid Third Party Liability Act, is a 119th Congress bill sponsored by Rep. Crenshaw, Dan [R-TX-2] (R-TX); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-hr-497
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-497
- Congress: 119
- Title: Medicaid Third Party Liability Act
- Status: introduced
- Introduced: 2025-01-16
- Sponsor: Rep. Crenshaw, Dan [R-TX-2] (R-TX)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

**States would have to verify third-party health coverage before Medicaid pays.** The bill would repeal special exceptions that let Medicaid pay first for preventive pediatric care and for services tied to child support enforcement and would create rules for how states contract with insurers about recovery and assignment of payment rights. - Families and children: Preventive pediatric care that previously qualified for a Medicaid-first exception would instead be billed to any legally liable third-party insurer when coverage exists. - State Medicaid programs and enrollees: States would be required to collect and verify whether an individual has third-party coverage, and after January 1, 2026, the federal government would not pay for services for which the state did not obtain and verify that information. - Health insurers and plans: States could contract with insurers, including group and self-insured plans, managed care organizations, and pharmacy benefit managers, to delegate recovery rights or accept assignments of payment rights from beneficiaries.

## Provisions PRIA read

- More time for states to comply: benefit, low. If enacted, States that need new State laws to meet these rules would get extra time. They would not be treated as out of compliance until the first day of the first calendar quarter after their next regular session ends. In States with two‑year sessions, each year would count as a separate session…
- Stricter Medicaid checks for other insurance: cost, high. If enacted, Medicaid applications would ask if you have other health insurance and the plan name. States would need to get and verify this information. For care paid after January 1, 2026, the federal match would not pay if the State did not verify it. This could add paperwork for applicants and pu…
- Ends special carve‑outs in Medicaid recovery: mixed, medium. If enacted, the bill would remove two special rules in Medicaid’s third‑party liability section. This could change how some services and payments are treated when another payer is responsible. The change would start upon enactment.
- States may let insurers recover payments: mixed, medium. If enacted, starting after January 1, 2026, State contracts with health insurers would have to say if the State lets the insurer recover from other responsible parties and if any assigned rights are transferred. If a State chooses this, it would need to assure the federal government that State law…

## Related bills

- 119-hr-3151: SHIPS for America Act of 2025
- 119-hr-137: TCJA Permanency Act
- 119-hr-2570: Maximum Pressure Act
- 119-hr-4895: Afghan Adjustment Act
- 119-hr-1229: United States-Israel Defense Partnership Act of 2025
- 119-hr-3132: CHOICE for Veterans Act of 2025

## Sources
- [119-hr-497 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/497)

## Related
- [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151)
- [119-hr-137: TCJA Permanency Act](https://policyrisk.com/legislation/119-hr-137)
- [119-hr-2570: Maximum Pressure Act](https://policyrisk.com/legislation/119-hr-2570)
- [119-hr-4895: Afghan Adjustment Act](https://policyrisk.com/legislation/119-hr-4895)
- [119-hr-1229: United States-Israel Defense Partnership Act of 2025](https://policyrisk.com/legislation/119-hr-1229)
- [119-hr-3132: CHOICE for Veterans Act of 2025](https://policyrisk.com/legislation/119-hr-3132)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-497 (as of 2025-12-21).