This bill would change title XIX of the Social Security Act to allow State Medicaid programs to offer comprehensive, coordinated care through a health home specifically for people with sickle cell disease. Beginning January 1, 2026, the Secretary may approve State plan amendments that focus on sickle cell disease. States that get such approval must provide dental and vision services to enrolled individuals, even if those services are not provided to other Medicaid beneficiaries or if comparability rules would otherwise apply. The bill also requires states with a sickle cell disease-focused amendment to submit a report, by the last day of the 8th fiscal quarter the amendment is in effect, on quality of care (with recovery-related outcomes), access to care, and total health care expenditures for enrolled individuals. The Secretary must specify the measures for those reports. The Centers for Medicare & Medicaid Services must publish best practices by June 30, 2026, based on clinical guidelines and consultation with providers and patient groups. The bill defines an eligible individual with sickle cell disease as someone eligible for Medicaid who has sickle cell disease, and it defines sickle cell disease as an inherited blood disorder identified by newborn screening or genetic testing.
No publicly available information on overall costs or federal budget effects is included in the bill text. The bill text does require that States provide dental and vision services to individuals enrolled in a sickle cell disease-focused health home, but it does not include cost estimates or funding details.
The bill’s sponsors designed it to enable State Medicaid programs to provide comprehensive, coordinated health home services for people with sickle cell disease, to ensure dental and vision care for enrollees, to require reporting on quality, access, and spending, and to have CMS publish best practices based on clinical guidelines and stakeholder input.
No publicly available information.