Medicaid; provide coverage for outpatient services by border city university-affiliated pediatric teaching hospitals.
Impact
The bill is designed to ensure that the costs of providing outpatient services to children in these specialized hospitals do not exceed those charged by hospitals within Mississippi. By doing so, it aims to prevent financial disparities that may occur when children in need of specialized pediatric care are treated across state lines. This change impacts the way healthcare services are billed and the financial structures surrounding Medicaid reimbursement, aligning local practices with federal standards particularly seen in methodologies used by the Medicare Program.
Summary
House Bill 896 aims to create a new section in the Mississippi Code of 1972, specifically Section 43-13-117.6, which mandates that the Division of Medicaid shall reimburse outpatient hospital services provided to eligible Medicaid beneficiaries under the age of twenty-one at border city university-affiliated pediatric teaching hospitals. This legislation reflects a targeted effort to enhance access to pediatric healthcare for children in Mississippi, particularly those living near the state border who might otherwise seek treatment out-of-state. The bill establishes a framework whereby reimbursements will be determined by reasonable costs, with interim payments and a year-end cost settlement in line with federal law.
Contention
Though the bill passed with commendable intentions, discussions surrounding its implementation raised concerns about potential challenges. Some lawmakers expressed apprehension about the adequacy of reimbursement rates, fearing that they might not truly reflect the high costs associated with providing quality pediatric care. Additionally, there is an ongoing debate regarding the efficiency of Medicaid funding and whether the state can realistically support such measures amidst budget constraints. The need for waivers and state plan amendments, as indicated in the bill, may also introduce bureaucratic hurdles that could delay access to care for vulnerable populations.
To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.