Accelerating Kids’ Access to Care Act

II 116TH CONGRESS 2D SESSION S. 4717 To amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes. IN THE SENATE OF THE UNITED STATES SEPTEMBER 24, 2020 Mr. GRASSLEY (for himself, Mr. BENNET, Mr. PORTMAN, Mr. BROWN, Mr. HAWLEY, and Mrs. MURRAY) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Accelerating Kids’ Ac- 4 cess to Care Act’’. 5 VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS 2 •S 4717 IS SEC. 2. STREAMLINED SCREENING AND ENROLLMENT 1 PROCESS FOR ELIGIBLE OUT-OF-STATE MED- 2 ICAID PROVIDERS. 3 (a) IN GENERAL.—Section 1902(kk) of the Social Se- 4 curity Act (42 U.S.C. 1396a(kk)) is amended by adding 5 at the end the following new paragraph: 6 ‘‘(10) STREAMLINED SCREENING AND ENROLL- 7 MENT PROCESS FOR ELIGIBLE OUT-OF-STATE PRO- 8 VIDERS.— 9 ‘‘(A) IN GENERAL.—Subject to subsection 10 (a)(65), the State adopts a streamlined screen- 11 ing and enrollment process for eligible out-of- 12 State providers. 13 ‘‘(B) STREAMLINED SCREENING AND EN- 14 ROLLMENT PROCESS.—For purposes of sub- 15 paragraph (A), the term ‘streamlined screening 16 and enrollment process’ means a process that 17 enables an eligible out-of-State provider to en- 18 roll as a provider in the State plan on a sim- 19 plified and streamlined basis in accordance with 20 the requirements of subparagraph (D). 21 ‘‘(C) ELIGIBLE OUT-OF-STATE PRO- 22 VIDER.—For purposes of subparagraph (A), the 23 term ‘eligible out-of-State provider’ means, with 24 respect to a State, a pediatric provider that fur- 25 nishes medical services to a child (or to an 26 VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS 3 •S 4717 IS adult if such services are to treat a condition 1 that presented during childhood) for which pay- 2 ment is available under the State plan under 3 this title, if— 4 ‘‘(i) the provider is located in another 5 State and is enrolled as a provider in good 6 standing under the State plan of such 7 other State; and 8 ‘‘(ii) with respect to the category of 9 provider to which such provider belongs, 10 the Secretary has determined there is a 11 limited risk of fraud, waste, or abuse for 12 purposes of determining the level of screen- 13 ing to be conducted under section 14 1866(j)(2)(B). 15 ‘‘(D) REQUIREMENTS.—For purposes of 16 subparagraph (B), the requirements of this sub- 17 paragraph are the following: 18 ‘‘(i) An eligible out-of-State provider 19 that elects to be and is enrolled in the pro- 20 gram established under this title in accord- 21 ance with the process established by the 22 Secretary under section 2(b) of the Accel- 23 erating Kids’ Access to Care Act is en- 24 rolled in the State plan under this title 25 VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS 4 •S 4717 IS without being subject to any additional 1 screening and enrollment activities re- 2 quired by the State. 3 ‘‘(ii) An eligible out-of-State provider 4 that is enrolled in the State plan through 5 the streamlined screening and enrollment 6 process shall be enrolled for a period of 5 7 years before being required to obtain re- 8 validation. 9 ‘‘(iii) An eligible out-of-State provider 10 that is enrolled in the State plan through 11 the streamlined screening and enrollment 12 process shall be permitted to order all 13 clinically necessary follow-up care, includ- 14 ing with respect to the prescribing of medi- 15 cations.’’. 16 (b) COORDINATION WITH MEDICARE.—The Sec- 17 retary shall establish a process for permitting a provider 18 the option, when enrolling in the program established 19 under the Medicare program under title XVIII of the So- 20 cial Security Act pursuant to subpart P of part 424 of 21 title 42, Code of Federal Regulations (or any successor 22 regulation), to elect, at the same time, to enroll in the 23 Medicaid program under title XIX of such Act for pur- 24 poses of all State plans under such title XIX. The Sec- 25 VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS 5 •S 4717 IS retary may utilize the Medicare Provider Enrollment, 1 Chain and Ownership System (referred to as ‘‘PECOS’’), 2 or another national, standardized, and widely accessible 3 platform to establish such process. 4 (c) CONFORMING AMENDMENTS.— 5 (1) Section 1902(a)(77) of such Act (42 U.S.C. 6 1396a(a)(77)), is amended by inserting ‘‘enroll- 7 ment,’’ after ‘‘screening,’’. 8 (2) Section 1902(kk) of such Act (42 U.S.C. 9 1396a(kk)), as amended by subsection (a), is further 10 amended— 11 (A) in the subsection heading, by inserting 12 ‘‘ENROLLMENT,’’ after ‘‘SCREENING,’’; and 13 (B) in paragraph (9), by striking ‘‘Noth- 14 ing’’ and inserting ‘‘Except as provided in para- 15 graph (10)(D)(i), nothing’’. 16 (3) Section 2107(e)(1)(F) of such Act (42 17 U.S.C. 1397gg(e)(1)(F)) is amended by inserting 18 ‘‘enrollment,’’ after ‘‘screening,’’. 19 (d) EFFECTIVE DATE.— 20 (1) IN GENERAL.—Except as provided in para- 21 graph (2), the amendments made by this section 22 take effect on January 1, 2021. 23 (2) EXCEPTION FOR STATE LEGISLATION.—In 24 the case of a State plan for medical assistance under 25 VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS 6 •S 4717 IS title XIX of the Social Security Act or a State child 1 health plan under title XXI of such Act which the 2 Secretary of Health and Human Services determines 3 requires State legislation (other than legislation ap- 4 propriating funds) in order for the plan to meet the 5 additional requirements imposed by the amendments 6 made by this section, such State plan shall not be 7 regarded as failing to comply with the requirements 8 of such title solely on the basis of its failure to meet 9 these additional requirements before the first day of 10 the first calendar quarter beginning after the close 11 of the first regular session of the State legislature 12 that begins after the date of the enactment of this 13 Act. For purposes of the previous sentence, in the 14 case of a State that has a 2-year legislative session, 15 each year of such session shall be deemed to be a 16 separate regular session of the State legislature. 17 Æ VerDate Sep 11 2014 05:39 Oct 15, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S4717.IS S4717 kjohnson on DSK79L0C42PROD with BILLS