[Congressional Record Volume 171, Number 113 (Monday, June 30, 2025)]
[Senate]
[Pages S4125-S4126]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 2787. Mr. GRASSLEY submitted an amendment intended to be proposed
by him to the bill H.R. 1, to provide for reconciliation pursuant to
title II of H. Con. Res. 14; which was ordered to lie on the table; as
follows:
At the appropriate place, insert the following:
SEC. ___. 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--
``(i) adopts and implements a process to allow an eligible
out-of-State provider to enroll under the State plan (or a
waiver of such plan) to furnish items and services to, or
order, prescribe, refer, or certify eligibility for items and
services for, qualifying individuals without the imposition
of screening or enrollment requirements by such State that
exceed the minimum necessary for such State to provide
payment to the eligible out-of-State provider under the State
plan (or a waiver of such plan), such as the provider's name
and National Provider Identifier (and such other information
specified by the Secretary); and
``(ii) provides that 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 so
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--
[[Page S4126]]
``(I) that is located in any other State;
``(II) that--
``(aa) was determined by the Secretary to have a limited
risk of fraud, waste, and abuse for purposes of determining
the level of screening to be conducted under section
1866(j)(2), has been so screened under such section
1866(j)(2), and is enrolled in the Medicare program under
title XVIII; or
``(bb) was determined by the State agency administering or
supervising the administration of the State plan (or a waiver
of such plan) of such other State to have a limited risk of
fraud, waste, and abuse for purposes of determining the level
of screening to be conducted under paragraph (1) of this
subsection, has been so screened under such paragraph (1),
and is enrolled under such State plan (or a waiver of such
plan); and
``(III) that has not been--
``(aa) excluded from participation in any Federal health
care program pursuant to section 1128 or 1128A;
``(bb) 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 any successor regulation), or
State law; or
``(cc) 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).
``(ii) Qualifying individual.--The term `qualifying
individual' means an individual under 21 years of age who is
enrolled under the State plan (or waiver of such plan).
``(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.--The amendments made by this section
shall take effect on the date that is 3 years after the date
of enactment of this section.
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