The bipartisan Accelerating Kids' Access to Care Act (H.R. 5900), sponsored by Reps. Joseph Kennedy, III, D-Mass., Jaime Herrera Beutler, R-Wash., and Ben Ray Lujan, D-N.M., would improve children's access to needed out-of-state health care by streamlining the Medicaid provider screening and enrollment process.
- Children on Medicaid whose needs cannot be met by health care providers in their home states often incur delays in being able to access the care they need across state lines. Some state Medicaid programs require out-of-state providers to be screened and enrolled into their program—even if the provider is already enrolled and in good standing in their home Medicaid program and in Medicare. This additional enrollment process consumes valuable time and resources, increases program costs and delays a children’s access to care.
- The Accelerating Kids' Access to Care Act seeks to facilitate access to care and remove these burdensome and costly processes. The legislation:
- Creates a limited pathway for children's health care providers to enroll in multiple state Medicaid programs if certain requirements are met.
- Establishes the following requirements to be enrolled in such a pathway:
- the providers are in the lowest category for potential program integrity issues
- the providers are enrolled in good standing in Medicare
- the providers are enrolled in good standing in their own home state Medicaid program
- Stipulates that providers would be those caring for children and for people age 18 or older if their condition onset before age 18. This is meant to improve continuity of care and recognize that some young adult specialty care may still be provided by pediatric providers—e.g., Duchenne muscular dystrophy, spinal muscular atrophy, sickle cell disease and young adult cancers.
- Focuses only on the screening and enrollment of providers, not on authorization of care by an out-of-state provider or payment rates for such care—leaving both issues within the purview of state Medicaid agencies.
The Accelerating Kids' Access to Care Act will improve children’s access to essential health care while eliminating administrative burdens for providers and states. Please co-sponsor H.R. 5900.