This bill amends existing law to establish minimum Medicaid reimbursement rates for structured day program services provided to beneficiaries eligible for brain injury services. It expands the current law, which previously only covered community residential services, to include structured day program services. Specifically, the bill mandates that the reimbursement rate for these structured day program services be set at the average of the reimbursement rates for Day Habilitation Services Tiers D and E, which is approximately $9.38 for every 15 minutes of service. This ensures that individuals receiving treatment for brain injuries have access to adequate funding for these essential services.

Additionally, the bill clarifies definitions related to brain injury services and the providers of such services. It defines "brain injury service" to encompass a range of community-based services, including residential, day care, and home care services for Medicaid beneficiaries with traumatic or non-traumatic brain injuries. The bill also outlines the responsibilities of the Commissioner of Human Services to adopt necessary rules and regulations to implement these provisions. The act is set to 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