Who is affected and how:

• Out‑of‑State health care providers: Will be able to enroll more easily in a State’s Medicaid or waiver program to serve children and youth under 21. They will submit only minimal identifying data (e.g., name and NPI) and, if approved, receive a five‑year enrollment term unless terminated or excluded earlier. This lowers administrative burden and may speed access to multi‑state care for pediatric services.

• Children and youth under age 21 on Medicaid (and their families): Likely gain improved access to more providers, including specialized or telehealth providers located in other States, which could reduce wait times and geographic gaps in pediatric services.

• State Medicaid agencies: Must build or modify enrollment systems, procedures, and oversight mechanisms to accept minimal information enrollments, manage five‑year enrollments, and perform any necessary checks or monitoring. These changes may require staff time, IT work, and procedural updates.

• Program integrity and oversight entities: Will need to ensure that streamlined enrollments do not compromise fraud, waste, or abuse safeguards; States retain authority to terminate or exclude providers, but processes for vetting and monitoring may need strengthening.

• Budget and administrative implications: Because the text does not provide dedicated federal funding, States may absorb implementation costs (IT upgrades, staffing, administrative changes), which could be treated as an unfunded mandate for some jurisdictions.

Overall effect: The legislation is targeted and operational — it reduces enrollment friction for out‑of‑State providers serving Medicaid‑eligible children while requiring States to adapt systems and processes; benefits to beneficiaries should include broader provider access, but States face implementation work and potential costs.