What does Preamble of Kids’ Access to Primary Care Act of 2025 do?

This bill proposes to amend title XIX of the Social Security Act. The stated purpose is to renew the application of the Medicare payment rate floor to primary care services furnished under the Medicaid program. The bill was introduced in the House of Representatives on February 18, 2025.

What does SHORT TITLE. of Kids’ Access to Primary Care Act of 2025 do?

This bill is formally titled the Kids' Access to Primary Care Act of 2025.

What does RENEWAL OF APPLICATION OF MEDICARE PAYMENT RATE FLOOR TO of Kids’ Access to Primary Care Act of 2025 do?

This section amends the Social Security Act to renew the Medicare payment rate floor for primary care services furnished under Medicaid. The payment floor requires rates to be at least 100% of the Medicare Part B rate or, if greater, the 2009 Medicare conversion factor rate. The amendments expand the types of providers eligible for the payment floor, including physicians with specific specialties, advanced practice clinicians, and rural health clinics. The bill defines exclusions to primary care services, specifically those provided in hospital emergency departments. Managed care entities are required to ensure payments to providers for primary care services are at least equal to the amounts set forth by the Secretary. The amendments apply to contracts entered into on or after the date of enactment of this Act.

What does STUDY. of Kids’ Access to Primary Care Act of 2025 do?

This section mandates a study by the Secretary of Health and Human Services regarding children enrolled in State Medicaid plans and health care providers receiving payments for primary care services. The study must compare enrollment and provider participation numbers before and after a specified date, one year and one month after the Act's enactment. It also requires a comparison of health care provider payment rates for primary care services across states, using specific indexes. The indexes to be used include a Medicaid fee index, a Medicaid-to-Medicare fee index, and a Medicaid fee change index. The Medicaid fee index compares a state's average fee to the national average. The Medicaid-to-Medicare fee index compares a state's Medicaid fee to the corresponding Medicare fee. The Medicaid fee change index compares fees before and after the specified date. The study is authorized $200,000 for fiscal year 2026, to be available until expended.

What does SENSE OF CONGRESS REGARDING USE OF BRIGHT FUTURES GUIDELINES. of Kids’ Access to Primary Care Act of 2025 do?

This section expresses the sense of Congress that health care providers should offer early and periodic screening, diagnostic, and treatment services. These services should be provided in accordance with the guidelines outlined in the American Academy of Pediatrics' ``Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents'’. The definition of these services references section 1905(r) of the Social Security Act (42 U.S.C. 1396d(r)).

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Kids’ Access to Primary Care Act of 2025

Last updated: 2/18/2025 · Introduced: 2/18/2025

Author: Kim Schrier (D-WA)

TL;DR (AI)

This bill renews and expands a payment floor for primary care services under Medicaid, requiring rates to be at least 100% of the Medicare Part B rate or the 2009 Medicare conversion factor rate for eligible providers.
The bill directs the Secretary of Health and Human Services to conduct a study analyzing children's Medicaid enrollment, provider participation, and primary care payment rates before and after the Act's enactment.
Congress expresses its belief that healthcare providers should offer early and periodic screening, diagnostic, and treatment services aligned with the American Academy of Pediatrics’ Bright Futures guidelines.

119th Congressin committeeOfficial page

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Other Sections

Includes provisions on preamble, short title., and 3 more.

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