Bill > S760

This bill, known as the Kids' Access to Primary Care Act of 2025, aims to renew and expand the Medicare payment rate floor for primary care services under Medicaid. The bill ensures that primary care services provided by specific healthcare professionals will be reimbursed at a rate not less than 100 percent of the Medicare Part B payment rate. The expanded coverage now includes physicians in family medicine, internal medicine, pediatric medicine, and obstetrics and gynecology, as well as their subspecialties, provided they are board-certified. Additionally, the bill extends coverage to advanced practice clinicians working under supervised conditions, rural health clinics, federally-qualified health centers, nurse practitioners, physician assistants, and certified nurse-midwives. The legislation also requires managed care entities to ensure appropriate payment rates and includes provisions to exclude emergency department services from the primary care service definition. To assess the impact of these changes, the bill mandates a comprehensive study by the Secretary of Health and Human Services, comparing enrollment numbers, healthcare provider payments, and fee rates across states before and after implementation. The study will use specific indexes to evaluate Medicaid fee structures and changes, with $200,000 authorized for the research in fiscal year 2026.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/760/all-info