Streamlined screening and enrollment of providers of maternity, labor, and delivery services in neighboring States

(a) Application to Medicaid Section 1902(kk) of the Social Security Act (42 U.S.C. 1396a(kk)) is amended by adding at the end the following new paragraph: (10) Streamlined enrollment process for eligible out-of-State providers of maternity, labor, and delivery services (A) In general The State adopts and implements a process that enables an eligible out-of-State provider to enroll as a provider in the State plan without imposing any screening requirements that are in addition to the requirements imposed on in-State providers. An eligible out-of-State provider that enrolls in the State plan through such process shall be so enrolled for a 5-year period (unless the provider is terminated or excluded from participation during such period) and may revalidate such enrollment through such process for subsequent 5-year periods. (B) Eligible out-of-State provider In this paragraph, the term eligible out-of-State provider means, with respect to a State, a provider— (i) that furnishes maternity, labor, and delivery services (as defined in subsection (uu)(1)), or provides orders or referrals for such services, for which payment is available under the State plan of the State; (ii) that is located in a neighboring State (as defined by the Secretary); (iii) with respect to which the Secretary has determined there is a limited risk of fraud, waste, or abuse for purposes of determining the level of screening to be conducted under section 1866(j)(2)(B); (iv) that has been screened under such section 1866(j)(2)(B) for purposes of enrolling in the Medicare program under title XVIII or the State plan of the State in which such provider is located; and (v) that has not been excluded from participation in the Medicare program under such title or the Medicaid program under this title.. (b) Conforming amendments (1) Section 1902(a)(77) of the Social Security Act (42 U.S.C. 1396a(a)(77)) is amended by inserting enrollment, after screening,. (2) Section 1902(kk) of such Act (42 U.S.C. 1396a(kk)), as amended by subsection (a), is further amended— (A) in the subsection heading, by inserting Enrollment, after Screening,; and (B) in paragraph (9), by striking Nothing and inserting Except as provided in paragraph (10), nothing. (c) Application to CHIP Section 2107(e)(1)(G) of such Act (42 U.S.C. 1397gg(e)(1)(G)) is amended by inserting enrollment, after screening,. (d) Guidance on screening and enrolling out-of-State providers of maternity, labor, and delivery services Not later than January 1, 2028, the Secretary of Health and Human Services shall issue (and update as the Secretary determines necessary) guidance to State Medicaid and CHIP directors on best practices for screening and enrolling out-of-State providers of maternity, labor, and delivery services in accordance with paragraph (10) of section 1902(kk) of the Social Security Act (42 U.S.C. 1396a(kk)) and section 2107(e)(1)(G) of such Act (42 U.S.C. 1397gg(e)(1)(G)) (as added and amended by this section) and including best practices for screening and enrolling out-of-State providers in managed care plans. (e) Effective date The amendments made by this section take effect on January 1, 2028.