Bill Summary – FastDemocracy

68th Legislature                                                                                                    HB 147.1
                                                   HOUSE BILL NO. 147
                                                INTRODUCED BY J. GILLETTE
    BY REQUEST OF THE CHILDREN, FAMILIES, HEALTH, AND HUMAN SERVICES INTERIM COMMITTEE
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   A BILL FOR AN ACT ENTITLED: “AN ACT CREATING AN ENHANCED MEDICAID REIMBURSEMENT RATE
   FOR PROVIDERS OF CERTAIN CHILDREN'S MENTAL HEALTH SERVICES TO INCREASE ACCESS TO
   IN-STATE CARE FOR HIGH-RISK CHILDREN WITH MULTIAGENCY SERVICE NEEDS; CREATING A
   REPORTING REQUIREMENT; PROVIDING A DEFINITION; PROVIDING RULEMAKING AUTHORITY; AND
   PROVIDING AN EFFECTIVE DATE AND A TERMINATION DATE.”
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   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
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              NEW SECTION. Section 1.       Enhanced rate to increase access to in-state mental health services
   for high-risk children with multiagency service needs -- reporting requirement -- rulemaking. (1) In an
   effort to avoid the placement of high-risk children with multiservice agency needs in out-of-state residential
   treatment facilities, the department shall pay an enhanced medicaid reimbursement rate when an in-state
   provider of psychiatric residential treatment facility or therapeutic group home services provides treatment to a
   child who meets criteria established by the department. The criteria must be related to:
              (a)    the age of the child; or
              (b)    the acuity of the child's treatment needs.
              (2)    (a) For the fiscal year beginning July 1, 2023, the reimbursement rate for psychiatric residential
   treatment facility and therapeutic group home services provided to a child meeting the age or acuity criteria
   established pursuant to this section is the higher of:
              (i)    133% of the rate in effect on July 1, 2022, for an in-state provider of the service; or
              (ii)   the rate adopted by the department for an in-state provider of the service for fiscal year 2024.
              (b)    The rate provided for in subsection (2)(a) must be increased in each subsequent fiscal year by
   the provider rate increase approved by the legislature for children's mental health services for that fiscal year.
              (3)    The department shall annually determine, in consultation with providers of psychiatric
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68th Legislature                                                                                                      HB 147.1
   residential treatment facility and therapeutic group home services, the criteria a child must meet for treatment to
   qualify for the enhanced reimbursement rate. The department shall notify providers of the determination no later
   than:
              (a)    May 15 for fiscal year 2024; and
              (b)    March 30 for subsequent fiscal years.
              (4)    The department shall adopt rules regarding the manner in which it will make the enhanced
   payments, including the frequency with which the payments will be made.
              (5)    (a) A provider that receives an enhanced reimbursement rate under this section shall:
              (i)    provide to the department a summary of the diagnoses, behaviors, and ages for the medicaid-
   eligible children receiving services from the provider in fiscal year 2023; and
              (ii)   report annually to the department on the diagnoses, behaviors, and ages of the medicaid-
   eligible children receiving services from the provider during the fiscal year in which the provider receives an
   enhanced reimbursement rate.
              (b)    The department shall report the information required under subsection (5)(a) to the legislature
   in accordance with 5-11-210.
              (6)    For the purposes of this section, the term "high-risk child with multiagency service needs" has
   the meaning provided in 52-2-302.
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              NEW SECTION. Section 2.       Codification instruction. [Section 1] is intended to be codified as an
   integral part of Title 53, chapter 6, part 1, and the provisions of Title 53, chapter 6, part 1, apply to [section 1].
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              NEW SECTION. Section 3.       Effective date -- contingency. (1) [This act] is effective on the later of
   July 1, 2023, or the date that the department of public health and human services certifies to the code
   commissioner that the centers for medicare and medicaid services has approved a state plan amendment for
   the enhanced reimbursement rate.
              (2)    The director of the department of public health and human services shall submit certification
   within 15 days of receiving notice of approval of the state plan amendment.
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68th Legislature                                                                                         HB 147.1
              NEW SECTION. Section 4.   Termination. [Section 1] terminates June 30, 2027.
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