Bill > H968

This bill directs the Office of Medicaid to establish a bundled payment pilot program for individuals with complex health issues, including behavioral health conditions, drawing on models from the federal Centers for Medicare and Medicaid Services' Bundled Payments for Care Improvement Initiative. The program will involve a single, predetermined payment for a defined period of care, known as an "episode of care," which could cover acute care hospital stays, related services up to 90 days post-discharge, and post-acute care services from facilities like skilled nursing homes or home health agencies. This bundled payment will encompass all services provided by the hospital, physicians, and other healthcare professionals during the episode. To support patients, especially those with behavioral health needs, the program will assign a case counselor with relevant expertise and cultural competence to coordinate services and ensure access. The program also emphasizes addressing geographic accessibility and ensuring that participating patients receive culturally and linguistically appropriate healthcare services.