This bill amends existing law to establish a minimum Medicaid reimbursement rate for structured day program services provided to beneficiaries eligible for brain injury services. The current law primarily addresses community residential services, but this amendment expands the scope to include structured day program services. Specifically, the bill stipulates that the reimbursement rate for these structured day program services will be equal to the average 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 previous rate of $3.65 for every 15 minutes of service.

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 on or after that date, as well as to any Medicaid managed care contracts executed or renewed thereafter.

Statutes affected:
Introduced: 30:4D-7