House Bill No. by Representative Phelps amends R.S. 46:977.24(A)(6) to enhance Medicaid coverage through the TEFRA option for children with disabilities. The bill specifies that, in addition to requiring a level of care typically provided in a hospital or skilled nursing facility, a child may also qualify if they have a documented need for emergency care related to sickle cell anemia. Specifically, if a child presents for emergency care in a hospital more than once a month within the last twelve months, this frequency can demonstrate the medical necessity for hospitalization to stabilize their condition.

The amendment aims to ensure that children with severe health conditions, particularly those suffering from sickle cell anemia, receive appropriate Medicaid coverage that reflects their healthcare needs. By clarifying the eligibility criteria, the bill seeks to provide better access to necessary medical services for affected children, thereby improving their overall health outcomes.

Statutes affected:
HB595 Engrossed: 46:24(A)(6)
HB595 Enrolled: 46:24(A)(6)
HB595 Act 294: 46:24(A)(6)