Bill > HR5178

This bill aims to amend the Social Security Act to enable state Medicaid programs to provide comprehensive, coordinated care through health homes specifically for individuals with sickle cell disease (SCD), a serious inherited blood disorder. Starting January 1, 2026, states can submit plan amendments to create SCD-focused health homes that will provide specialized services. These health homes will be required to offer dental and vision services to eligible SCD patients, regardless of existing Medicaid service requirements. States implementing these health homes must submit quarterly reports to the Secretary of Health and Human Services detailing the quality of care, healthcare access, and total healthcare expenditures for SCD patients. The bill defines an eligible individual as a Medicaid-eligible person with SCD who may or may not have previously received health home services. By June 30, 2026, the Centers for Medicare & Medicaid Services must publish best practices for designing and implementing these specialized health homes, developed in consultation with medical specialists and patient advocacy organizations. This legislation represents a significant effort to improve healthcare coordination and support for individuals living with sickle cell disease by creating targeted, comprehensive care pathways within the Medicaid system.