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Advancing Care for Exceptional Kids Act of 2019

Thursday, April 25, 2019   (0 Comments)
Posted by: Amy Breedlove
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I wanted to provide an update on a piece of legislation that was not included in the April FAL Briefing Memo.  This past Thursday, April 18, the President signed H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019 into law.  The H.R. 1839 package included legislation supported by APTA known as the “Advancing Care for Exceptional Kids Act of 2019” (ACE Kids Act, S. 317/H.R. 1226).

The ACE Kids Act expands a state option for health homes for children with complex medical conditions under Medicaid. The ACE Kids Act addresses existing challenges—identified by families and physicians—facing children with medically complex conditions by expanding access to patient-centered, pediatric-focused coordinated care models tailored for these children across multiple providers and services, and by easing access to out-of-state care.  The legislation builds off of current law to establish specially designed health homes for children with medically complex conditions beginning on Oct. 1, 2022. Participation is voluntary for children and their families, providers and states. States that opt to create these health homes will receive a higher federal matching rate (15 percent above regular matching rate for the state, not to exceed 90 percent) for six months.

The legislation requires that by Oct. 1, 2020 the Secretary of Health and Human Services issue guidance to state Medicaid directors on best practices for ensuring this population receives prompt care from out-of-state providers when medically necessary. States have flexibility to develop their own methodology for determining payment, including the use of alternative payment models.

The broader legislative package also provides $20 million for the Money Follows the Person demonstration for fiscal 2019. The demonstration is aimed at transitioning Medicaid beneficiaries from facilities to community-based long-term support services.

best,

Justin Elliott

Vice President, Government Affairs

APTA

 

 



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