S. 721 — Sickle Cell Disease Comprehensive Care Act

This section expands the Medicaid health home program—which provides coordinated care management services to eligible individuals with chronic conditions—to include eligible individuals with sickle cell disease beginning January 1, 2026 (i.e., Medicaid enrollees diagnosed with sickle cell disease, as confirmed by newborn screening or genetic test, regardless of prior health home enrollment). The section further establishes special rules for state plan amendments (SPAs) designed primarily to furnish health home services to such individuals (i.e., sickle cell disease-focused SPAs), including the following: (1) a requirement that states with SPAs approved on or after January 1, 2026, furnish dental and vision services to enrollees, irrespective of Medicaid comparability requirements or whether such services are provided to other beneficiaries; (2) a requirement that states submit a report to the Secretary after the first eight fiscal year quarters of the SPA's implementation, covering quality of care (with focus on recovery outcomes), access to care, and total health care expenditures for enrollees (using measures specified by the Secretary); (3) a directive for the Secretary to publish best practices for designing and implementing such SPAs by June 30, 2026, based on clinical guidelines from medical specialty societies and developed in consultation with sickle cell providers and patient advocacy groups; and (4) definitions of "eligible individual with sickle cell disease" and "sickle cell disease."