SPONSOR: Sen. Hoffner & Sen. S. McBride & Rep. K. Johnson Sens. Gay, Hansen, Sokola, Wilson DELAWARE STATE SENATE 152nd GENERAL ASSEMBLY SENATE CONCURRENT RESOLUTION NO. 156 REQUESTING THE DIVISION OF MEDICAID AND MEDICAL ASSISTANCE TO ISSUE A REPORT ASSESSING HOME CARE IN DELAWARE.
SPONSOR: Sen. Hoffner & Sen. S. McBride & Rep. K. Johnson Sens. Gay, Hansen, Sokola, Wilson
SPONSOR: Sen. Hoffner & Sen. S. McBride & Rep. K. Johnson
Sens. Gay, Hansen, Sokola, Wilson
SPONSOR:
Sen. Hoffner & Sen. S. McBride & Rep. K. Johnson
Sens. Gay, Hansen, Sokola, Wilson
DELAWARE STATE SENATE
152nd GENERAL ASSEMBLY
SENATE CONCURRENT RESOLUTION NO. 156
REQUESTING THE DIVISION OF MEDICAID AND MEDICAL ASSISTANCE TO ISSUE A REPORT ASSESSING HOME CARE IN DELAWARE.
WHEREAS, Delawareans prefer to obtain care in their homes; and WHEREAS, as the medical field and health-care industry is evolving to provide an increasing amount of home care to patients and clients in their homes as opposed to hospitals, clinics, and doctor offices; and WHEREAS, as the demographics and age distribution in Delaware are becoming increasingly older, resulting in increasing demand statewide for home care services; and WHEREAS, in addition to aging populations, there are children and other medically dependent people, who either require or would benefit from care delivered to them in their home setting; and WHEREAS, the Delaware Division of Medicaid and Medical Assistance is responsible for overseeing the governance of Medicaid, a critical program for providing Delawareans from all walks of life with lifesaving and life sustaining care; and WHEREAS, access to accurate and robust data is important for policy makers and home care providers for assessing the changing care needs of the population, monitoring trends in the home care workforce, and developing appropriate strategic action plans. NOW, THEREFORE: BE IT RESOLVED by the Senate of the 152 nd General Assembly of the State of Delaware, the House of Representatives concurring therein, that the Division of Medicaid and Medical Assistance (DMMA) is requested to study and complete a report to the General Assembly by March 31, 2025, regarding the use of home care services for the calendar years of 2020 through 2023. The study will report on the home care services included in Appendix B of the SMDL-21-003, specifically the private duty nursing HCPCS codes S9123, S9124, G0299, and G0300 and LTSS HCPCS codes G0156, S5130, S5125, S5150, and T1005. For the calendar years of 2020 though 2023, DMMA will list these HCPCS codes and their corresponding fees for service, related fee schedules, or reasonably equivalent Medicaid reimbursement rate. BE IT FURTHER RESOLVED that for the calendar years of 2020 through 2023, the study will report on each qualified home care code at the state and county level, listing fee for service data and Medicaid Managed Care data by individual MCOs separately, as follows: (1) The number of unduplicated recipients by age or pre-defined age-related category and any pre-defined enrollment category. (2) The monetary value of claims. (3) The authorized units of service as compared to the billed Medicaid units of service. (4) The volume of units of service, monetary claims, and number of recipients by provider name and National Provider Identifier (NPI). (5) The average and median time, in days, between initial application by beneficiaries and eligibility determinations, with times for approval of services or denial of services, reported separately. (6) The average and median time, in days, between the approval of services and plan of care development, authorization of services and start of services. BE IT FURTHER RESOLVED that the study will include an analysis and consideration of emerging trends in home care, an analysis of access to home care services, and an analysis of the home care workforce. DMMA will complete a contract with a vendor to conduct the study and produce the report. DMMA will also post the study publicly upon its completion.
WHEREAS, Delawareans prefer to obtain care in their homes; and
WHEREAS, as the medical field and health-care industry is evolving to provide an increasing amount of home care to patients and clients in their homes as opposed to hospitals, clinics, and doctor offices; and
WHEREAS, as the demographics and age distribution in Delaware are becoming increasingly older, resulting in increasing demand statewide for home care services; and
WHEREAS, in addition to aging populations, there are children and other medically dependent people, who either require or would benefit from care delivered to them in their home setting; and
WHEREAS, the Delaware Division of Medicaid and Medical Assistance is responsible for overseeing the governance of Medicaid, a critical program for providing Delawareans from all walks of life with lifesaving and life sustaining care; and
WHEREAS, access to accurate and robust data is important for policy makers and home care providers for assessing the changing care needs of the population, monitoring trends in the home care workforce, and developing appropriate strategic action plans.
NOW, THEREFORE:
BE IT RESOLVED by the Senate of the 152 nd General Assembly of the State of Delaware, the House of Representatives concurring therein, that the Division of Medicaid and Medical Assistance (DMMA) is requested to study and complete a report to the General Assembly by March 31, 2025, regarding the use of home care services for the calendar years of 2020 through 2023. The study will report on the home care services included in Appendix B of the SMDL-21-003, specifically the private duty nursing HCPCS codes S9123, S9124, G0299, and G0300 and LTSS HCPCS codes G0156, S5130, S5125, S5150, and T1005. For the calendar years of 2020 though 2023, DMMA will list these HCPCS codes and their corresponding fees for service, related fee schedules, or reasonably equivalent Medicaid reimbursement rate.
BE IT FURTHER RESOLVED that for the calendar years of 2020 through 2023, the study will report on each qualified home care code at the state and county level, listing fee for service data and Medicaid Managed Care data by individual MCOs separately, as follows:
(1) The number of unduplicated recipients by age or pre-defined age-related category and any pre-defined enrollment category.
(2) The monetary value of claims.
(3) The authorized units of service as compared to the billed Medicaid units of service.
(4) The volume of units of service, monetary claims, and number of recipients by provider name and National Provider Identifier (NPI).
(5) The average and median time, in days, between initial application by beneficiaries and eligibility determinations, with times for approval of services or denial of services, reported separately.
(6) The average and median time, in days, between the approval of services and plan of care development, authorization of services and start of services.
BE IT FURTHER RESOLVED that the study will include an analysis and consideration of emerging trends in home care, an analysis of access to home care services, and an analysis of the home care workforce. DMMA will complete a contract with a vendor to conduct the study and produce the report. DMMA will also post the study publicly upon its completion.
SYNOPSIS This resolution requests the Division of Medicaid and Medical Assistance to study and issue a report assessing the home care industry in Delaware. The DMMA is requested to use specified home care codes for their report and conduct various analyses. The DMMA is requested to make their report available for the public. Author: Senator Hoffner
SYNOPSIS
This resolution requests the Division of Medicaid and Medical Assistance to study and issue a report assessing the home care industry in Delaware. The DMMA is requested to use specified home care codes for their report and conduct various analyses. The DMMA is requested to make their report available for the public.
Author: Senator Hoffner