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 set at the average of the reimbursement rates for Day Habilitation Services Tiers D and E, which is approximately $9.89 for every 15 minutes of service. This addition aims to ensure that individuals receiving treatment for brain injuries have access to adequate funding for structured day programs.

In addition to the new provisions for structured day program services, the bill also clarifies the definitions of brain injury services and brain injury service providers. It maintains the existing framework for community-based services, residential services, day care services, and home care services for Medicaid beneficiaries with traumatic or non-traumatic brain injuries. The bill requires the Commissioner of Human Services to adopt necessary rules and regulations to implement these changes, and it will take effect 30 days after enactment, applying to services provided and Medicaid managed care contracts executed or renewed thereafter.

Statutes affected:
Introduced: 30:4D-7