Substitute Bill No. 5368 is a legislative proposal concerning Medicaid coverage for diapers, with an effective date of July 1, 2024. The bill defines "medical necessity" as a determination by a licensed physician, physician assistant, or advanced practice registered nurse that providing diapers to a child is essential to prevent or improve certain health conditions. These conditions include severe and persistent diaper dermatitis, urinary tract infections, or other skin diseases related to inadequate diaper hygiene, as well as developmental, psychiatric, or neurological conditions that result in an unusual need to void or delayed developmentally appropriate toileting behavior.

The bill mandates the Commissioner of Social Services to amend the Medicaid state plan to include coverage for diapers for children from birth to age three who have a medical necessity for them. Additionally, by September 1, 2025, the commissioner is required to report to the General Assembly's human services committee on the number of children deemed to have a medical necessity for diapers in the previous fiscal year, the cost to the state for providing this coverage, and the estimated savings on state Medicaid costs for treatment of health conditions that are prevented by access to diapers covered by Medicaid. The bill inserts a new section into the law, effective July 1, 2024, and does not include any deletions from current law.