Bill > S761

Introduced Session

This bill requires Medicaid fee-for-service (FFS) coverage of managed long term services and supports when the beneficiary is pending enrollment in a managed care organization (MCO). In doing so, the bill codifies existing Medicaid policy established in Medicaid Newsletter, Vol. 24, No. 14. Specifically, the bill requires the Division of Medical Assistance and Health Services in the Department of Human Services to provide Medicaid coverage via the FFS delivery system for eligible services provided by an assisted living residence, a comprehensive personal care home, an assisted living program, or an adult family care provider to an individual who is determined eligible for the Medicaid Managed Long Term Services and Supports program, but who is pending enrollment in a MCO contracted by the division to provide health care services to Medicaid recipients. FFS coverage provided under the bill will begin on the date on which the individual is determined clinically and financially eligible for services provided under the Medicaid Managed Long Term Services and Supports program, and will end on the date on which the individual's enrollment in a Medicaid MCO becomes effective. The bill directs the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to implement the provisions of the bill and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.

AI Summary

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Gordon Johnson (D)*, 

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 01/09/2024)

Official Document