Accelerating Kids’ Access to Care Act

To amend title XIX of the Social Security Act to streamline enrollment under the Medicaid program of certain providers across State lines, and for other purposes. 1. Short title This Act may be cited as the Accelerating Kids’ Access to Care Act 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) (10) Streamlined enrollment process for eligible out-of-State providers (A) In general The State adopts and implements a process that enables an eligible out-of-State provider to enroll as a participating provider in the State plan (or a waiver of such plan) without the imposition of additional screening requirements by the State, unless the State has a standard agreement with other States governing coverage and payment for services furnished to Medicaid-eligible children with medically complex conditions that was developed in accordance with guidance issued by the Secretary under section 1945A. 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 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 (I) that furnishes to a qualifying individual any item or service for which Federal financial assistance is available under the State plan (or a waiver of such plan); (II) that is located in any other State; (III) with respect to which the Secretary has determined (or, in the case of a provider for which no risk level determination has been made by the Secretary, the State agency administering or supervising the administration of the State plan (or a waiver of such plan) has determined) there is a limited risk of fraud, waste, and abuse for purposes of determining the level of screening to be conducted under section 1866(j)(2) (except that, if such State agency has designated a higher risk level for the provider than the Secretary, the State agency's designation shall apply); (IV) that has been screened under such section 1866(j)(2) and enrolled in the Medicare program under title XVIII, or screened under paragraph (1) of this subsection and enrolled in the State plan (or a waiver of such plan) in which such provider is located; and (V) that has not been excluded from participation in any Federal health care program pursuant to section 1128 or 1128A, 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 State law, or 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) of this subsection. (ii) Qualifying individual The term qualifying individual (iii) State The term State . (b) Conforming amendments (1) Section 1902(a)(77) of the Social Security Act ( 42 U.S.C. 1396a(a)(77) enrollment, screening, (2) The subsection heading for section 1902(kk) of such Act ( 42 U.S.C. 1396a(kk) Enrollment, Screening, (3) Section 2107(e)(1)(G) of such Act ( 42 U.S.C. 1397gg(e)(1)(G) enrollment, screening, (c) Effective date (1) In general Except as provided in paragraph (2), the amendments made by this section take effect on the date that is 2 years after the date of enactment of this Act. (2) Exception for State legislation In the case of a State plan under Medicaid or a State child health plan under CHIP which the Secretary determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, such State plan or State child health plan shall not be regarded as failing to comply with the requirements of Medicaid or CHIP, respectively, solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.

Summary: Accelerating Kids' Access to Care Act This bill requires state Medicaid programs to establish a process through which qualifying out-of-state providers may enroll as participating providers for five years without undergoing additional screening requirements, unless the state has an agreement with other states that governs coverage of children with medically complex conditions that is in accordance with specified guidance from the Centers for Medicare & Medicaid Services (CMS). Among other requirements, a qualifying provider must (1) serve individuals under the age of 21; (2) have previously been screened for Medicare participation or for participation in the Medicaid program of the state in which the provider is located; and (3) have been determined by the CMS or state Medicaid program to pose a limited risk of fraud, waste, or abuse.