This bill makes it easier for kids on Medicaid or CHIP to see doctors in another state. It tells states to set up a simple, fast way for certain out-of-state providers to sign up so they can treat these kids without extra red tape beyond what’s needed to pay the claim. Once enrolled, those providers can treat patients and also order tests, write prescriptions, make referrals, and confirm eligibility. Enrollment would last for five years unless the provider is kicked out or excluded.

Only providers who are considered low risk and are already enrolled in Medicare or another state’s Medicaid program can use this shortcut. They also cannot be excluded or terminated from federal or state health programs. The kids covered are those under age 21 who are enrolled in Medicaid or CHIP. The changes start three years after the bill becomes law.

• Who is affected: Children under 21 on Medicaid or CHIP; out-of-state providers who are low risk and already enrolled in Medicare or another state’s Medicaid; state Medicaid/CHIP programs that must set up the process.
• What changes: States must offer a streamlined enrollment with only minimal info required (like name and National Provider Identifier); enrolled providers can treat, prescribe, refer, and more for these kids for five years.
• When: Takes effect three years after enactment.