[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4758 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 4758
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.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 19, 2023
Mrs. Trahan (for herself and Mrs. Miller-Meeks) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Accelerating Kids' Access to Care
Act''.
SEC. 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 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' means,
with respect to a State, a 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' means, with respect to
an eligible out-of-State provider, an
individual under 21 years of age to whom the
provider furnishes items and services for the
treatment of a condition.
``(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.--
(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.
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