Accelerating Kids’ Access to Care Act of 2025
This bill requires states to establish a process through which qualifying out-of-state providers may temporarily treat children under Medicaid and the Children's Health Insurance Program (CHIP) without undergoing additional screening requirements.
Specifically, states must establish a process through which qualifying out-of-state providers may enroll for five years as participating providers to treat individuals under the age of 21 without undergoing additional screening requirements.
A qualifying out-of-state provider (1) must not have been excluded or terminated from participating in a federal health care program or state Medicaid program; and (2) must have been successfully enrolled in Medicare or a state Medicaid program based on a determination that the provider posed a limited risk of fraud, waste, or abuse.
The bill’s changes take effect three years after enactment.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1509 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 1509
To amend titles XIX and XXI of the Social Security Act to streamline
the enrollment process for eligible out-of-state providers under
Medicaid and CHIP.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 21, 2025
Mrs. Trahan (for herself and Mrs. Miller-Meeks) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act to streamline
the enrollment process for eligible out-of-state providers under
Medicaid and CHIP.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Accelerating Kids' Access to Care
Act of 2025''.
SEC. 2. STREAMLINED ENROLLMENT PROCESS FOR ELIGIBLE OUT-OF-STATE
PROVIDERS UNDER MEDICAID AND CHIP.
(a) In General.--Section 1902(kk) of the Social Security Act (42
U.S.C. 1396a(kk)) is amended by adding at the end the following new
paragraph:
``(10) Streamlined enrollment process for eligible out-of-
state providers.--
``(A) In general.--The State--
``(i) adopts and implements a process to
allow an eligible out-of-State provider to
enroll under the State plan (or a waiver of
such plan) to furnish items and services to, or
order, prescribe, refer, or certify eligibility
for items and services for, qualifying
individuals without the imposition of screening
or enrollment requirements by such State that
exceed the minimum necessary for such State to
provide payment to an eligible out-of-State
provider under such State plan (or a waiver of
such plan), such as the provider's name and
National Provider Identifier (and such other
information specified by the Secretary); and
``(ii) provides that an eligible out-of-
State provider that enrolls as a participating
provider in the State plan (or a waiver of such
plan) through such process shall be so enrolled
for a 5-year period, unless the provider is
terminated or excluded from participation
during such period.
``(B) Definitions.--In this paragraph:
``(i) Eligible out-of-state provider.--The
term `eligible out-of-State provider' means,
with respect to a State, a provider--
``(I) that is located in any other
State;
``(II) that--
``(aa) was determined by
the Secretary to have a limited
risk of fraud, waste, and abuse
for purposes of determining the
level of screening to be
conducted under section
1866(j)(2), has been so
screened under such section
1866(j)(2), and is enrolled in
the Medicare program under
title XVIII; or
``(bb) was determined by
the State agency administering
or supervising the
administration of the State
plan (or a waiver of such plan)
of such other State to have a
limited risk of fraud, waste,
and abuse for purposes of
determining the level of
screening to be conducted under
paragraph (1) of this
subsection, has been so
screened under such paragraph
(1), and is enrolled under such
State plan (or a waiver of such
plan); and
``(III) that has not been--
``(aa) excluded from
participation in any Federal
health care program pursuant to
section 1128 or 1128A;
``(bb) excluded from
participation in the State plan
(or a waiver of such plan)
pursuant to part 1002 of title
42, Code of Federal Regulations
(or any successor regulation),
or State law; or
``(cc) terminated from
participating in a Federal
health care program or the
State plan (or a waiver of such
plan) for a reason described in
paragraph (8)(A).
``(ii) Qualifying individual.--The term
`qualifying individual' means an individual
under 21 years of age who is enrolled under the
State plan (or waiver of such plan).
``(iii) State.--The term `State' means 1 of
the 50 States or the District of Columbia.''.
(b) Conforming Amendments.--
(1) Section 1902(a)(77) of the Social Security Act (42
U.S.C. 1396a(a)(77)) is amended by inserting ``enrollment,''
after ``screening,''.
(2) The subsection heading for section 1902(kk) of such Act
(42 U.S.C. 1396a(kk)) is amended by inserting ``enrollment,''
after ``screening,''.
(3) Section 2107(e)(1)(G) of such Act (42 U.S.C.
1397gg(e)(1)(G)) is amended by inserting ``enrollment,'' after
``screening,''.
(c) Effective Date.--The amendments made by this section shall take
effect on the date that is 3 years after the date of enactment of this
Act.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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