This bill mandates the Department of Health and Human Services to create an administrative day rate and a swing bed rate for specific hospital stays under the state Medicaid program. The new section, RSA 126-A:18-c, outlines that hospital stays will be covered when a client does not meet the criteria for acute inpatient care but cannot be discharged due to the unavailability of appropriate placements or the need for continuous care for a newborn. The bill specifies that the administrative day rate will include necessary pharmacy services and ancillary services, and it allows for coverage of up to five newborn administrative days, with the possibility of additional days through expedited prior authorization.

Additionally, the bill establishes a swing bed day rate for clients receiving approved nursing services in swing beds, clarifying that hospitals will not receive the acute inpatient rate for these days. It also stipulates that ancillary services not covered under the swing bed rate can be billed separately, and pharmacy services provided to clients in swing beds can be billed directly by pharmacies. The Department is tasked with adopting rules to set the rate methodology and criteria for these services. The act is set to take effect on July 1, 2025.