Rep. Katherine Clark is leading a renewed bipartisan push to bolster health equity by improving timely access to critical pediatric care when families must rely on out-of-state providers.
The Massachusetts Democrat on Wednesday introduced the Accelerating Kids’ Access to Care Act, which is designed to eliminate administrative hurdles and ensure families get the quick care or procedures their children need when facilities in their home state can’t provide highly specialized care.
The bill would empower states to let pediatric care providers use a streamlined screening and enrollment process when they need to enroll in another state’s Medicaid program, guaranteeing timely coverage and cutting “red tape and regulatory burdens that slow down, or, in certain cases, prohibit children from receiving the care they need,” Clark’s office said in a statement to MassLive.
“Kids with serious health conditions often can’t wait for care — and they shouldn’t have to,” Clark, the assistant Speaker of the House, said in a statement. “The Accelerating Kids’ Access to Care Act ensures that red tape and state lines don’t stand between children and life-saving medical care.”
Currently, when families must travel out-of-state to receive care, parents have to grapple with health care providers and state Medicaid officials just to find eligible providers. Once the State Medicaid Agency or Medicaid Managed Care Organization, as well as the child’s provider, determine what care must be delivered across state lines, the out-of-state provider must be screened and enrolled in the child’s home-state Medicaid program.
“More often than not, providers expend significant amounts of time to address these [state or Medicaid screening] requirements, which vary significantly between states,” more than 75 children’s advocates and health care providers — including the American Academy of Pediatrics, Boston Children’s Hospital and Children’s Hospital Association — wrote to lawmakers in a joint letter this week. “When this happens, access to care is delayed and, in some cases, the child’s health situation worsens.”
The advocates said the bill is a “commonsense” move that protects the integrity of Medicaid programs while creating a streamlined “screening pathway” that children’s hospitals and other providers can use on a voluntary basis. If they screen successfully, they can be enrolled in out-of-state Medicaid programs right away “if called upon to provide care for children,” the advocates wrote.
The bill would particularly benefit pediatric care providers in Massachusetts, a medical care leader that often provides specialized treatment for families from across the U.S.
Boston Children’s Hospital treats more children with rare diseases and complex conditions than any other hospital in the nation, with patients from all 50 states, according to Dr. Kevin Churchwell, president and CEO of the hospital.
“We see first-hand the importance of timely care and the potential threats that delays in care pose to the health and well-being of many patients,” he said in a statement. “This legislation is a crucial step toward ensuring that all patients receive the care they need, when they need it. On behalf of our patients and their families, we thank the bill’s sponsors and urge its enactment.”
Rep. Jaime Herrera Beutler, Republican of Washington, joined Clark in introducing the legislation; Herrera Beutler previously introduced the bill with former Rep. Joe Kennedy III in early 2020. A bipartisan group of senators, including Democratic Sens. Michael Bennet of Colorado and Sherrod Brown of Ohio, and Republicans Chuck Grassley of Iowa and Rob Portman of Ohio, introduced the bill in the upper chamber.