This bill amends existing law to establish minimum Medicaid reimbursement rates for structured day program services provided to beneficiaries eligible for brain injury services. The current law primarily addresses community residential services, but this bill expands the scope to include structured day program services. Specifically, it mandates that the reimbursement rate for these services be equal to the average of the reimbursement rates for Day Habilitation Services Tiers D and E, which is currently set at $9.09 for every 15 minutes of service. This is a significant increase from the existing rate of $3.65 for every 15 minutes of structured day program services.

Additionally, the bill clarifies definitions related to brain injury services and providers, ensuring that the services covered include community-based, residential, day care, and home care services for Medicaid beneficiaries with traumatic or non-traumatic brain injuries. The Commissioner of Human Services is tasked with adopting necessary rules and regulations to implement the provisions of this act. The bill will take effect 30 days after enactment and will apply to services provided and Medicaid managed care contracts executed or renewed on or after that date.

Statutes affected:
Introduced: 30:4D-7