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H.R. 1509: Accelerating Kids’ Access to Care Act of 2025

The "Accelerating Kids’ Access to Care Act of 2025" aims to improve the enrollment process for eligible out-of-state healthcare providers under the Medicaid and Children's Health Insurance Program (CHIP). The key components of the bill are as follows:

Streamlined Enrollment Process

The bill proposes changes to the Social Security Act to allow states to adopt a streamlined process for out-of-state providers to enroll and provide services to qualifying individuals. This includes:

States must implement a process that allows eligible out-of-state providers to enroll without additional screening or requirements beyond what is necessary for payment. This would require minimal information such as the provider's name and National Provider Identifier (NPI).
Once enrolled through this streamlined process, a provider will be retained as a participating provider for a period of five years, unless they are terminated or excluded from participation.

Definitions of Key Terms

The bill defines several essential terms to clarify which providers and individuals are impacted:

Eligible Out-of-State Provider: A provider located in another state who meets specific criteria, including:
- Screened for fraud, waste, and abuse, and enrolled in the Medicare program or in the Medicaid program of the other state.
- Must not be excluded from any Federal or state health care programs.
Qualifying Individual: An individual under 21 years old who is enrolled in the state Medicaid or CHIP program.
State: Refers to any of the 50 states or the District of Columbia.

Amendments to the Social Security Act

To implement these changes, the bill proposes several amendments to specific sections of the Social Security Act related to Medicaid and CHIP enrollment and screening processes: