,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bcgb  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ai1 #bjbc,mr4   
,grassley 7= himself1 ,mr4 ,b5net1 ,mrs4
 ,blackburn1 ,ms4 ,cortez ,ma/o1 ,mr4   
,boozman1 ,mr4 ,br[n1 ,mr4 ,vance1 ,ms4 
,/ab5[1 ,mr4 ,hawley1 ,mr4 ,kelly1 ,mrs4
 ,capito1 ,ms4 ,s9ema1 ,mr4 ,wick]1 ,mr4
 ,m>key1 ,mr4 ,van ,holl51 ,mr4 ,w>nock1
 ,mr4 ,casey1 & ,ms4 ,baldw97 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,f9ance  ,a ,,bill  
,to am5d title ,,xix ( ! ,social        
,security ,act to /reaml9e enrollm5t "u 
! ,m$icaid program ( c]ta9 provid]s     
across ,/ate l9es1 & = o!r purposes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,accel]at+ ,kids' ,access to ,c>e     
,act4  #b4 ,/reaml9$ enrollm5t process =
 eligible out-(-,/ate provid]s "u       
,m$icaid & ,,*ip  7a7 ,9 g5]al ,section 
#aijb7kk7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;a7kk77 is am5d$ by 
add+ at ! end ! foll[+ new p>agraph3    
7#aj7 ,/reaml9$ enrollm5t process =     

eligible out-(-,/ate provid]s  7,a7 ,9  
g5]al ,! ,/ate adopts & implem5ts a     
process t enables an eligible           
out-(-,/ate provid] to enroll z a       
p>ticipat+ provid] 9 ! ,/ate plan 7or a 
waiv] ( su* plan7 )\t ! imposition (    
additional scre5+ requirem5ts by !      
,/ate1 unless ! ,/ate has a /&>d        
agreem5t ) o!r ,/ates gov]n+ cov]age &  
paym5t = s]vices furni%$ to             
,m$icaid-eligible *ildr5 ) m$ically     
complex conditions t 0 develop$ 9       
accordance ) guidance issu$ by !        
,secret>y "u section #aide;,a4 ,an      
eligible out-(-,/ate provid] t enrolls z
 a p>ticipat+ provid] 9 ! ,/ate plan 7or
 a waiv] ( su* plan7 ?r\gh su* process  
%all be enroll$ = a #e-ye> p]iod unless 
! provid] is t]m9at$ or exclud$ f       
p>ticipation dur+ su* p]iod4  7,b7      
,def9itions ,9 ?is p>agraph3 7i7        
,eligible out-(-,/ate provid] ,! t]m    
eligible out-(-,/ate provid] means1 )   
respect to a ,/ate1 a provid]-- 7,i7 t  
furni%es to a qualify+ individual any   

item or s]vice = :i* ,f$]al f9ancial    
assi/ance is available "u ! ,/ate plan  
7or a waiv] ( su* plan72  7,,ii7 t is   
locat$ 9 any o!r ,/ate2  7,,iii7 )      
respect to :i* ! ,secret>y has det]m9$  
7or1 9 ! case ( a provid] = :i* no risk 
level det]m9ation has be5 made by !     
,secret>y1 ! ,/ate ag5cy adm9i/]+ or    
sup]vis+ ! adm9i/ration ( ! ,/ate plan  
7or a waiv] ( su* plan7 has det]m9$7 !re
 is a limit$ risk ( fraud1 wa/e1 & abuse
 = purposes ( det]m9+ ! level ( scre5+  
to be conduct$ "u section #ahff7;j77#b7 
7except t1 if su* ,/ate ag5cy has       
designat$ a high] risk level = ! provid]
 ?an ! ,secret>y1 ! ,/ate ag5cy's       
designation %all apply72  7,,iv7 t has  
be5 scre5$ "u su* section #ahff7;j77#b7 
& enroll$ 9 ! ,m$ic>e program "u title  
,,xviii1 or scre5$ "u p>agraph 7#a7 (   
?is subsection & enroll$ 9 ! ,/ate plan 
7or a waiv] ( su* plan7 9 :i* su*       
provid] is locat$2 &  7,v7 t has n be5  
exclud$ f p>ticipation 9 any ,f$]al     
heal? c>e program pursuant to section   

#aabh or #aabh;,a1 exclud$ f            
p>ticipation 9 ! ,/ate plan 7or a waiv] 
( su* plan7 pursuant to "p #ajjb ( title
 #db1 ,code ( ,f$]al ,regulations1 or   
,/ate law1 or t]m9at$ f p>ticipat+ 9 a  
,f$]al heal? c>e program or ! ,/ate plan
 7or a waiv] ( su* plan7 = a reason     
describ$ 9 p>agraph 7#h77;,a7 ( ?is     
subsection4  7ii7 ,qualify+ individual  
,! t]m qualify+ individual means1 )     
respect to an eligible out-(-,/ate      
provid]1 an individual "u #ba ye>s ( age
 to :om ! provid] furni%es items &      
s]vices = ! treatm5t ( a condition4     
7iii7 ,/ate ,! t]m ,/ate means #a ( !   
#ej ,/ates or ! ,di/rict ( ,columbia4  4
  7b7 ,con=m+ am5dm5ts  7#a7 ,section   
#aijb7;a77#gg7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7a77#gg77 is 
am5d$ by ins]t+ enrollm5t1 aft] scre5+14
  7#b7 ,! subsection head+ = section    
#aijb7kk7 ( su* ,act 7#db ,u4,s4,c4     
#acif;a7kk77is am5d$ by ins]t+          
,enrollm5t1 aft] ,scre5+14  7#c7        
,section #bajg7;e77#a77;,g7 ( su* ,act  

7#db ,u4,s4,c4 #acig;gg7e77#a77;,g77 is 
am5d$ by ins]t+ enrollm5t1 aft] scre5+14
  7c7 ,effective date  7#a7 ,9 g5]al    
,except z provid$ 9 p>agraph 7#b71 !    
am5dm5ts made by ?is section take effect
 on ! date t is #b ye>s aft] ! date (   
enactm5t ( ?is ,act4  7#b7 ,exception = 
,/ate legislation ,9 ! case ( a ,/ate   
plan "u ,m$icaid or a ,/ate *ild heal?  
plan "u ,,*ip :i* ! ,secret>y det]m9es  
requires ,/ate legislation 7o!r ?an     
legislation appropriat+ funds7 9 ord] = 
! plan to meet ! additional requirem5ts 
impos$ by ! am5dm5ts made by ?is        
section1 su* ,/ate plan or ,/ate *ild   
heal? plan %all n be reg>d$ z fail+ to  
comply ) ! requirem5ts ( ,m$icaid or    
,,*ip1 respectively1 solely on ! basis (
 its failure to meet ^! additional      
requirem5ts be=e ! fir/ day ( ! fir/    
cal5d> qu>t] beg9n+ aft] ! close ( !    
fir/ regul> session ( ! ,/ate           
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has

 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4