119-HR1509

Bill is currently in: House
Path to Law
House Senate President

119th CONGRESS

1st Session

H. R. 1509

1. Short title
2. Streamlined enrollment process for eligible out-of-state providers under Medicaid and CHIP

1. Short title

This Act may be cited as the "Accelerating Kids’ Access to Care Act of 2025".

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.