[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2415 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  2d Session
                                S. 2415

To amend title XIX of the Social Security Act to streamline enrollment 
of certain Medicaid providers and suppliers across State lines, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 12, 2018

  Mr. Grassley (for himself and Mr. Bennet) 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 and suppliers 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. FINDINGS.

    The Congress finds as follows:
            (1) Thankfully, most children are well. However, there is a 
        small subset of children with medically complex needs. Many of 
        these medically complex needs are congenital, but some are 
        acquired during childhood. Examples of children with medically 
        complex needs include children with Down syndrome, cancer, 
        cystic fibrosis, or Duchene muscular dystrophy.
            (2) Children with medically complex needs often require 
        health care from multiple specialty providers that are not 
        always located within their home State.
            (3) Children with medically complex needs and families on 
        Medicaid who require care from providers outside of their home 
        State must navigate a number of paperwork challenges that can 
        impede timely access to care.
            (4) Health care providers treating children from out-of-
        State face significant burdens in being screened and enrolled 
        to participate in the Medicaid program of the child being 
        treated.
            (5) Current Federal regulation and guidance from the Center 
        for Medicaid and CHIP Services allow States to rely on provider 
        screenings done by Medicaid contractors or by other State 
        Medicaid or CHIP programs.
            (6) The Provider Enrollment, Chain and Ownership System 
        (PECOS) is an existing national enrollment system for Medicare 
        providers and suppliers that is being expanded to support 
        better alignment between Medicare, Medicaid and the CHIP 
        program and that system could serve as a nationwide platform 
        for provider enrollment in Medicaid.
            (7) Congress recognizes the need for thorough screening of 
        providers and suppliers in the Medicare, Medicaid and CHIP 
        programs to prevent waste, fraud, and abuse.
            (8) A nationwide streamlined screening and enrollment 
        process for limited risk providers who care for children (and 
        the adults who have medically complex needs which began in 
        childhood) under the Medicaid and CHIP programs will accelerate 
        access to appropriate care. In addition, such a process has the 
        potential to strengthen program integrity efforts by requiring 
        thorough screening and vetting of providers.

SEC. 3. STREAMLINED SCREENING AND ENROLLMENT PROCESS FOR ELIGIBLE OUT-
              OF-STATE MEDICAID PROVIDERS AND SUPPLIERS.

    (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 screening and enrollment process for 
        eligible out-of-state providers and suppliers.--
                    ``(A) In general.--Subject to subsection (a)(65), 
                the State adopts a streamlined screening and enrollment 
                process for eligible out-of-State providers and 
                suppliers.
                    ``(B) Streamlined screening and enrollment 
                process.--For purposes of subparagraph (A), the term 
                `streamlined screening and enrollment process' means a 
                process that enables an eligible out-of-State provider 
                or supplier to enroll as a provider or supplier in the 
                State plan on a simplified and streamlined basis in 
                accordance with the requirements of subparagraph (D).
                    ``(C) Eligible out-of-state provider or supplier.--
                For purposes of subparagraph (A), the term `eligible 
                out-of-State provider or supplier' means a provider or 
                supplier of medical or other items or services 
                furnished to a child for which payment is available 
                under the State plan under this title that is located 
                in another State and with respect to which the 
                Secretary has determined there is a limited risk of 
                fraud, waste, or abuse for purposes of determining the 
                level of screening to be conducted under section 
                1866(j)(2)(B).
                    ``(D) Requirements.--For purposes of subparagraph 
                (B), the requirements of this subparagraph are the 
                following:
                            ``(i) An eligible out-of-State provider or 
                        supplier that elects to be and is enrolled in 
                        the program established under this title in 
                        accordance with the process established by the 
                        Secretary under section 2(b) of the 
                        Accelerating Kids' Access to Care Act is 
                        enrolled in the State plan under this title 
                        without being subject to any additional 
                        screening and enrollment activities required by 
                        the State.
                            ``(ii) An eligible out-of-State provider or 
                        supplier that is enrolled in the State plan 
                        through the streamlined screening and 
                        enrollment process shall be enrolled for a 
                        period of 5 years before being required to 
                        obtain revalidation.
                            ``(iii) An eligible out-of-State provider 
                        or supplier that is enrolled in the State plan 
                        through the streamlined screening and 
                        enrollment process shall be permitted to order 
                        all clinically necessary follow-up care, 
                        including with respect to the prescribing of 
                        medications.''.
    (b) Coordination With Medicare.--The Secretary shall establish a 
process for permitting a provider or a supplier, as the case may be, 
the option when enrolling in the program established under the Medicare 
program under title XVIII of the Social Security Act pursuant to 
subpart P of part 424 of title 42, Code of Federal Regulations (or any 
successor regulation), to elect, at the same time, to enroll in the 
Medicaid program under title XIX of such Act for purposes of all State 
plans under such title XIX. The Secretary may utilize the Medicare 
Provider Enrollment, Chain and Ownership System (referred to as 
``PECOS''), or another national, standardized, and widely accessible 
platform to establish such process.
    (c) Conforming Amendments.--
            (1) Section 1902(a)(77) of such Act (42 U.S.C. 
        1396a(a)(77)), is amended by inserting ``enrollment,'' after 
        ``screening,''.
            (2) Section 1902(kk) of such Act (42 U.S.C. 1396a(kk)), as 
        amended by subsection (a), is further amended--
                    (A) in the subsection heading, by inserting 
                ``Enrollment,'' after ``Screening,''; and
                    (B) in paragraph (9), by striking ``Nothing'' and 
                inserting ``Except as provided in paragraph (10)(D)(i), 
                nothing''.
            (3) Section 2107(e)(1)(F) of such Act (42 U.S.C. 
        1397gg(e)(1)(F)) is amended by inserting ``enrollment,'' after 
        ``screening,''.
    (d) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section take effect on January 1, 2019.
            (2) Exception for state legislation.--In the case of a 
        State plan for medical assistance under title XIX of the Social 
        Security Act or a State child health plan under title XXI of 
        such Act which the Secretary of Health and Human Services 
        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 shall not be regarded as failing to 
        comply with the requirements of such title 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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