Bill Details

S.752 - 119th Congress

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This bill would make it easier for certain doctors and other health care providers in one state to enroll in Medicaid in another state so they can treat children and young adults who are covered by Medicaid or CHIP. It is meant to reduce delays and paperwork when a child needs care from an out-of-state provider. The bill would let states use a simpler enrollment process for these providers, as long as they have already been checked for low fraud risk and are in good standing. Once enrolled, the provider would stay enrolled for five years unless they are removed for a serious reason.

  • It applies only to out-of-state providers who care for people under age 21 who are enrolled in Medicaid or a Medicaid waiver.
  • States could not require extra screening or paperwork beyond the minimum needed to pay the provider, such as basic identifying information and a National Provider Identifier.
  • To qualify, the provider must already be approved and screened as low risk for fraud, waste, and abuse, and must be enrolled in Medicare or in Medicaid in another state.
  • The provider must not be excluded, suspended, or terminated from federal health programs or state Medicaid programs for misconduct or similar reasons.

The bill would take effect three years after it becomes law.

Official Summaries

Accelerating Kids’ Access to Care Act

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.

Current Full Text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 752 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  1st Session
                                 S. 752

To amend title XIX of the Social Security Act to streamline enrollment 
  under the Medicaid program of certain providers across State lines.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 26, 2025

   Mr. Grassley (for himself, Mr. Bennet, Mr. Tillis, Mr. Reed, Mr. 
Sullivan, Mr. Warnock, Mr. Wicker, Mr. Coons, Mr. Rounds, Mrs. Murray, 
Mr. Boozman, Mr. Merkley, Mr. Hawley, Mr. Fetterman, Ms. Murkowski, Mr. 
   Kaine, Mrs. Blackburn, Mr. Peters, Mr. Schmitt, Mr. Warner, Mrs. 
Capito, Ms. Warren, Ms. Collins, Ms. Duckworth, Mr. Daines, Mr. Kelly, 
 Mr. Ricketts, Mr. Booker, and Mrs. Fischer) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XIX of the Social Security Act to streamline enrollment 
  under the Medicaid program of certain providers across State lines.

    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''.

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 the eligible out-of-State 
                        provider under the 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 
section.
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