HR1509-119

Introduced

To amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP.

119th Congress Introduced Feb 21, 2025

Legislative Progress

Introduced
Introduced Committee Passed
Feb 21, 2025

Mrs. Trahan (for herself and Mrs. Miller-Meeks) introduced the following …

Summary

What This Bill Does

The "Accelerating Kids' Access to Care Act of 2025" makes it easier for out-of-state doctors and healthcare providers to treat children enrolled in Medicaid or CHIP across state lines. Currently, providers must go through separate, often duplicative enrollment processes in each state where they want to treat patients. This bill requires states to create a streamlined enrollment process that accepts providers who have already been vetted and approved by Medicare or another state's Medicaid program, and guarantees those providers can stay enrolled for 5 years.

Who Benefits and How

Telehealth companies that serve children on Medicaid or CHIP are the biggest winners - they can now enroll in multiple states with minimal paperwork instead of navigating 50 different bureaucratic processes. Out-of-state specialty care providers (like pediatric mental health specialists, rare disease experts, or other specialists) benefit by gaining access to new patient populations without jumping through redundant enrollment hoops. Children in rural or underserved areas benefit by getting better access to specialists who may not be available in their state, especially through telehealth services.

Who Bears the Burden and How

State Medicaid and CHIP agencies must create and implement this new streamlined enrollment system within 3 years, which requires updating their IT systems, training staff, and changing administrative procedures. In-state healthcare providers may face increased competition from out-of-state providers who can now more easily serve Medicaid/CHIP patients in their state, potentially reducing their patient base or market share.

Key Provisions

  • States must accept out-of-state providers who have already been screened for fraud risk by Medicare or another state's Medicaid program, without imposing additional screening requirements beyond the basics (name, National Provider Identifier, and minimal information specified by HHS)
  • Providers who enroll through this streamlined process receive a guaranteed 5-year enrollment period (unless they're terminated for fraud or other serious violations)
  • The streamlined process only applies to providers treating children under age 21 who are enrolled in Medicaid or CHIP
  • Providers must be in good standing - not excluded or terminated from Medicare, Medicaid, or other federal healthcare programs
  • States have 3 years from the bill's enactment to implement the new enrollment process
Model: claude-sonnet-4.5
Generated: Dec 24, 2025 23:02

Evidence Chain:

This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.

Primary Purpose

Streamlines Medicaid and CHIP enrollment for out-of-state healthcare providers who treat children under 21, allowing them to enroll with minimal requirements if already screened by Medicare or their home state

Policy Domains

Healthcare Medicaid CHIP Provider Enrollment

Legislative Strategy

"Reduce administrative barriers to pediatric care access by enabling out-of-state providers (especially telehealth providers) to serve Medicaid/CHIP children without redundant state-by-state enrollment processes"

Likely Beneficiaries

  • Telehealth companies serving pediatric patients
  • Out-of-state specialty care providers
  • Children in rural or underserved areas needing access to specialists

Likely Burden Bearers

  • State Medicaid agencies (must implement new enrollment process)
  • Potentially in-state providers facing increased competition

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Medicaid CHIP
Actor Mappings
"state_agency"
→ State Medicaid/CHIP administering agency
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

3 terms
"eligible out-of-State provider" §1902(kk)(10)(B)(i)

A provider located in another state that: (1) has been screened for fraud risk and enrolled in Medicare OR screened and enrolled in another state's Medicaid/CHIP program, AND (2) has not been excluded or terminated from any federal health care program

"qualifying individual" §1902(kk)(10)(B)(ii)

An individual under 21 years of age enrolled in the state Medicaid or CHIP plan

"State" §1902(kk)(10)(B)(iii)

One of the 50 States or the District of Columbia

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology