The bipartisan Accelerating Kids' Access to Care Act (S. 1544/H.R. 3089) would improve children's access to needed out-of-state health care by streamlining the Medicaid provider screening and enrollment process.
- Children on Medicaid must often travel to different states to receive care when the services they need are not available in their own state. This is particularly true for children with medically complex conditions who must regularly access highly specialized providers found in children’s hospitals, which are often treating children from many different states at any given time.
- Today, children on Medicaid needing care outside their home states often experience delays because 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 with their home Medicaid program and in Medicare. This process of enrolling in multiple Medicaid programs consumes valuable time and resources, increases program costs and delays children's access to care.
- The Accelerating Kids' Access to Care Act would better facilitate access to care across state lines that many children need and remove burdensome and costly processes. The legislation creates a new pathway for pediatric providers to enroll in multiple state Medicaid programs if certain requirements are met, including that they are in the lowest category for potential program integrity issues and are enrolled in their home state Medicaid program.
- Providers eligible for this streamlined pathway would be those caring for children and adults whose conditions onset before age 18. This is meant to improve continuity of care and recognizes that some specialty care to young adults may still be provided by pediatric providers (e.g., Duchenne, spinal muscular atrophy, sickle cell, young adult cancers).
- The legislation focuses only on the screening and enrollment of providers and not on authorization of care by an out-of-state provider nor payment rates for any such care, leaving both issues within the purview of state Medicaid agencies.
- The Accelerating Kids' Access to Care Act has strong bipartisan support: original co-sponsors on S. 1544 include Sens. Grassley, R-Iowa, Bennet, D-Colo., Portman, R-Ohio, and Brown, D-Ohio. Original co-sponsors on H.R. 3089 include Reps. Clark, D-Mass., and Herrera Beutler, R-Wash.
- This legislation will improve children's access to essential health care, while eliminating administrative burdens for providers and states. We ask lawmakers to please co-sponsor S. 1544/H.R. 3089 and for Congress to enact the Accelerating Kids' Access to Care Act this year.
