STAT

Opinion: Medicaid’s unnecessary barriers delay care for children with complex needs

Reforming the process for enrolling physicians in Medicaid programs will make it easier for children to get the care they need.

Children with complex medical conditions often need care in pediatric hospitals outside of their home states. Some need that care right away. Yet the red tape for enrolling and vetting out-of-state hospitals and clinicians often delays the care these children need and makes it more difficult and expensive. That needs to change.

An estimated 2 million children living in the United States need the kind of care that is available only at a limited number of U.S. hospitals — diagnosis and treatment of rare and ultra-rare diseases and disorders; complex treatment and surgery for congenital problems or serious traumatic injuries; organ transplantation; and more. The care for many of these children is fully or partly covered by Medicaid, whose joint federal-state structure perpetuates the delays in their treatment.

Before a clinician can provide Medicaid-related care, federal law requires that she or he must undergo a background screening before enrolling

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