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2017 Session

Budget Amendments - SB900 (Member Request)

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Chief Patron: Hanger
Determination of Reimbursement Tiers (language only)

Item 313 #2s

Item 313 #2s

Health and Human Resources
Department of Behavioral Health and Developmental Services

Language

Page 321, after line 22, insert:

"U.  The Department of Behavioral Health and Developmental Services in collaboration with the Department of Medical Assistance Services, and stakeholders, shall develop additional criteria for information that shall be considered in addition to the SIS score in determining the reimbursement  tiers for waiver services. The additional information that may be considered includes the diagnosis of the individual, past medical and behavioral history, or other information that could be helpful in determining the appropriate services needs of individuals in the Developmental Disability waivers.  The Department of Medical Assistance Services shall have the authority to implement this change effective upon passage of this Act, and prior to the completion of any regulatory process undertaken in order to effect such change."



Explanation

(This amendment adds language directing the Department of Behavioral Health Developmental Services in cooperation with the Department of Medical Assistance Services to modify regulations to allow additional information to be considered in addition to the SIS score for determining the reimbursement level for Medicaid waiver services. Currently, the reimbursement tier for providers of services in the developmental disability waivers is determined solely by the SIS score. Some individuals have needs that are difficult to fully capture with the SIS, so this language would allow other information to be considered in determining the score.)