Bill > HB1128

This bill establishes the Medicaid Care Transition Program to address challenges in moving Medicaid patients from emergency departments and hospitals to appropriate post-acute care settings. The program requires county Medicaid managed care plans and other responsible entities to create care transition units that will actively work to find suitable placements for patients within 24 hours, including seeking out-of-network options if in-network providers are unavailable. If a placement cannot be found within 48 hours, the responsible entity must notify the Department of Human Services, which will then take an active role in resolving placement barriers. This may involve convening discussions with clinical leaders, state agencies, and insurance representatives to address issues like network adequacy, payment problems, or clinical challenges. The department is required to collect data on these interventions and submit an annual report to legislative committees detailing the number of placement difficulties, actions taken, and corrective measures implemented. The bill aims to reduce extended emergency department wait times, minimize patient stress, and ensure more efficient healthcare service delivery for Medicaid enrollees, with the program taking effect 60 days after passage.

Health and Social Services

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=H&type=B&bn=1128