Accelerating Kids' Access to Care Act
This bill requires state Medicaid programs to establish a process through which qualifying out-of-state providers may temporarily treat children without undergoing additional screening requirements. It also requires pass-through pricing models for covered drugs under Medicaid.
Specifically, states must establish a process through which qualifying providers may enroll for five years as participating providers to treat individuals under the age of 21 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).
A qualifying provider (1) must not have been excluded or terminated from participating in a federal health care program or state Medicaid program; and (2) must have been successfully enrolled in Medicare or a state Medicaid program based on a determination that the provider posed a limited risk of fraud, waste, or abuse.
In addition, the bill requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with pharmacy benefit managers under Medicaid.
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.
Miller-Meeks moved to suspend the rules and pass the bill, as amended.
(consideration: CR H5292-5295)
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H5292-5293)
Agreed to without objection.