Provides medical assistance coverage for medical services provided qualifying eligible recipients for community based care.
Impact
This legislation is expected to have a significant impact on state laws concerning healthcare provisions and reimbursement policies. By defining community medical services and establishing eligibility criteria for recipients, the bill aims to streamline care that can prevent unnecessary hospitalizations and improve health maintenance for individuals with chronic conditions. Moreover, it will introduce coordination among health providers to ensure comprehensive care planning.
Summary
Bill S0975 proposes to enhance medical assistance coverage by introducing a reimbursement methodology for community medical services offered by licensed providers. The goal is to facilitate medical care for eligible recipients who have frequent emergency department visits or are at risk of requiring more intensive care, such as hospitalization or nursing home admission. The bill specifically targets services that can help manage health conditions more effectively within community settings, thereby improving patient health outcomes.
Contention
Notable discussion points surrounding S0975 include concerns about the adequacy of funding for these community services and the potential administrative burden involved in coordinating care among various health providers. Stakeholders express the necessity for clear guidelines to regulate community medical services while ensuring that they operate within the scope of licensed practice. There may be opposition from some factions worried about how such a model could affect existing healthcare services or lead to resource allocation issues.
All Medicaid programs operated by EOHHS would not reimburse home care providers less than fee-for-service rates adopted by rate review recommendations of the office of health insurance commissioners.
Authorizes the executive office of health and human services to establish a program providing coverage for nutritional assistance and medically tailored meals for certain beneficiaries where there is a clinical need.