• Talking Points
  • April 20, 2018

Summary of Accelerating Kids' Access to Care Act (S. 2415)

The Accelerating Kids' Access to Care Act (S. 2415) is bipartisan legislation, sponsored by Sen. Chuck Grassley, R-Iowa, and Sen. Michael Bennet, D-Colo., that seeks to improve children's access to essential health care by streamlining the Medicaid provider screening and enrollment process.

  • Currently, if a child enrolled in Medicaid needs to see a provider outside of the child's home state, the out-of-state provider must first be screened and enrolled in the child's home-state Medicaid program, in addition to being enrolled within their own state's Medicaid program.
  • This process of enrolling in additional Medicaid programs consumes valuable time and resources, and delays a child's access to care, care that the child's home-state Medicaid program has already authorized based on a determination that the child's needs could not be met by in-state providers.

The Accelerating Kids' Access to Care Act recognizes that, in certain cases, children may need to receive care from providers outside of their home state and simplifies the Medicaid out-of-state provider enrollment process.

  • Current law and regulations permit state Medicaid programs to rely on a provider screening done by another state or by Medicare as part of the provider screening and enrollment process, but these policies are not universally followed.
  • S. 2415 will establish a streamlined federal enrollment pathway for limited risk providers caring for children. The legislation requires the Secretary of Health and Human Services to establish the new enrollment pathway, and allows the Secretary to utilize the current Medicare Provider Enrollment, Chain and Ownership System (PECOS) or another standardized national system. Only providers who provide care to children and who pose a limited risk of fraud, waste or abuse are eligible to participate.
  • If providers elect this option, they will be enrolled in other state Medicaid programs as needed without any additional screening requirements applied by the home state of the child. Providers who choose to enroll in the national enrollment and screening process will be enrolled for five years.