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As a mother, physician, and congresswoman, I’ve seen firsthand the struggles families face when seeking specialized medical care for their children. This is particularly true for those dealing with rare and complex pediatric conditions, where the stakes couldn’t be higher. It’s alarming that accessing the necessary treatment often means navigating a sea of bureaucratic hurdles that can delay care—sometimes for months or even years.
Just last week, the House passed my legislation, H.R. 4758, the Accelerating Kids’ Access to Care Act, aimed at dismantling these barriers. This bill is not just a policy change; it’s a response to the urgent needs of families across Iowa and the country. A study from the American Academy of Pediatrics reveals that children with complex medical needs often wait two to three months for out-of-state care, a timeline that can lead to severe health consequences.
The Accelerating Kids’ Access to Care Act addresses this critical issue by streamlining the enrollment process for out-of-state pediatric providers under Medicaid. By allowing states to implement a simplified enrollment system, we can significantly reduce the delays that have long plagued families in need of urgent care. Additionally, once a provider is enrolled, they will remain active for five years unless otherwise terminated, ensuring more stability in healthcare delivery.
Another key component of this bill is the requirement for transparency in prescription drug pricing, specifically targeting the harmful practices of pharmacy benefit managers (PBMs). PBMs often engage in spread pricing, where they charge higher amounts to the state than they pay to pharmacies for the same drugs. The new regulations will prohibit this practice in Medicaid, ensuring that payments made by PBMs reflect actual costs, thus protecting families from inflated drug prices.
The bipartisan support for H.R. 4758 is heartening, with endorsements from over 215 organizations, including the Children’s Hospital Association and the Leukemia and Lymphoma Society. This consensus underscores the urgent need for reform in pediatric care access.
As we move forward, it’s crucial for the Senate to pass H.R. 4758. This legislation is a practical step toward ensuring that all children can access the specialized care they need without unnecessary delays. By streamlining the enrollment process and promoting fair pricing practices, we can significantly improve healthcare access for families across Iowa and beyond. The time for decisive action is now.
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