House Bill No. [insert bill number] aims to expand Medicaid coverage for children through the TEFRA option by adding a new eligibility criterion. Specifically, the bill enacts R.S. 46:977.24(A)(8), which states that a child may qualify for Medicaid if, due to their disability, they require emergency care in a hospital emergency department more than once a month. This provision allows for eligibility even if the child is not admitted to the hospital, provided that a physician determines that emergency room visits are necessary to stabilize a condition related to the child's disability, such as acute chest syndrome.

The proposed law modifies existing eligibility criteria for the TEFRA option, which already includes requirements such as being a Louisiana resident, being under the age of nineteen, and having a recognized disability. By adding this new criterion, the bill aims to ensure that children who frequently require emergency medical attention due to their disabilities can access necessary Medicaid coverage, thereby improving their healthcare outcomes.