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Consolidated Appropriations Act, 2026Section 6101 › Proposal

A state must let an out-of-state provider enroll without extra screening

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6101, Sec. 6101. Written by .

A state must let an out-of-state provider enroll without extra screening

The document says “requiresWho acts: State Medicaid agenciesHow: statuteSec. 6101 in the PDF
What the document says

“adopts and implements a process to allow an eligible out-of-State provider to enroll under the State plan (or a waiver of such plan) to furnish items and services to, or order, prescribe, refer, or certify eligibility for items and services for, qualifying individuals without the imposition of screening or enrollment requirements by such State that exceed the minimum necessary for such State to provide payment”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6101

Section 6101 adds a new paragraph (10) to section 1902(kk) of the Social Security Act. A state must adopt and implement a process letting an eligible out-of-State provider enroll under the state plan or a waiver to furnish, order, prescribe, refer for or certify eligibility for items and services for qualifying individuals, without screening or enrollment requirements beyond the minimum needed to pay the provider, such as the provider's name and National Provider Identifier.

What the document actually says

“adopts and implements a process to allow an eligible out-of-State provider to enroll under the State plan (or a waiver of such plan) to furnish items and services to, or order, prescribe, refer, or certify eligibility for items and services for, qualifying individuals without the imposition of screening or enrollment requirements by such State that exceed the minimum necessary for such State to provide payment”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6101
That sentence, in plain words

A state must set up a way for a doctor in another state to sign up. The state may not ask for more than it needs to pay that doctor.

What this is about

A state runs its own health plan for people with low income. A doctor must sign up with the state to be paid. Sign-up used to differ from state to state.

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