Sec. 4. Guidance on coordinating care from out-of-State providers
311 words·~1 min read·
/bill/115/hr/3325/ih/section-4A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Not later than one year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue guidance to State Medicaid Directors on best practices for using out-of-State providers to provide care to children with medically complex conditions (as defined in section 1947 of the Social Security Act, as added by section 2 of this Act), including guidance regarding— arranging access to, and providing payment for, care for such children furnished by such out-of-State providers (including when provided in emergency and non-emergency situations); reducing barriers for such children receiving care from such providers in a timely fashion; and processes for screening and enrolling such providers in the State plan under title XIX of the Social Security Act (or a waiver of the plan), including efforts to streamline such processes or reduce the burden of such processes on providers.
In carrying out subsection (a), the Administrator of the Centers for Medicare & Medicaid Services shall issue a request for information to seek input from children with medically complex conditions (as defined in section 1947 of the Social Security Act, as added by section 2 of this Act) and their families, States, providers (including children’s hospitals, hospitals, pediatricians, and other providers), managed care plans, children’s health groups, family and beneficiary advocates, and other stakeholders with respect to coordinating the care for such children furnished by out-of-State providers.
Not later than 90 days after the issuance of the best practice guidelines under subsection (a), States with a State plan amendment in effect under section 1947 of the Social Security Act shall submit to the Secretary of Health and Human Services, and make publicly available on the appropriate Internet website of the State, information on how the State is achieving the purposes described in such subsection, including any of such best practices adopted by the State.