Health Care Policy And Financing - Digest of Bills

Digest of Bills - 1997

HEALTH CARE POLICY AND FINANCING

H.B. 97-1063 Medical assistance - new program - revisions - appropriation. Subject to receipt of waivers from the federal government, establishes a program in the department of health care policy and financing to provide disabled children who would otherwise be institutionalized an opportunity to receive in-home care. Sets eligibility requirements, including requiring the cost to be no higher than institutionalized care. Gives priority to children who are on the waiting list for other in-home programs and children of parents who will be able to return to work because of the program. Authorizes eligibility for children who would be medicaid eligible except for a temporary increase in their parent's income. Directs the medical services board to adopt rules to govern the program. Permits the department to authorize parents to hire and manage care providers and to provide assistance to parents in developing care management skills. Directs the department to study the advisability of setting a maximum parental income level for all children's medicaid waiver programs and to report to the joint budget committee by November 1, 1997, with its findings and recommendations. Appropriates $22,400 for this program.

Repeals the exclusion of persons with developmental disabilities from participating in the home and community-based services for the elderly, blind, and disabled program.

Subject to appropriation by the general assembly, effective July 1, 1998, expands state optional services covered by medicaid to include all prosthetic devices, rather than those only surgically implanted, and specifies that medically necessary augmentative communications devices are included.

For nonemergency services, requires medicaid clients who are also covered by another primary insurer to follow the protocols of that insurer including using in-network providers and obtaining referrals from a primary care physician. Establishes that the client is liable for services if he or she fails to follow the protocols. Creates an exception if the insurer or provider fails to communicate the protocols to the client. Allows the insurer and client to enter into a written agreement whereby the client will be personally liable for nonemergency, nonreimbursable expenses. Directs the medical services board to approve a form for such agreements.

Continues the federally mandated $90 personal needs allowance for certain veterans and their surviving spouses.

APPROVED by Governor June 3, 1997
EFFECTIVE June 3, 1997