HI HB93

Requires insurers contracting with the Department of Human Services to provide a medically complex add-on payment of 40 percent of the Medicaid base rate for long-term care facility patients with complex medical, behavioral, mental health, or cognitive needs who are waitlisted at acute care hospitals.

Long-term care facilities must provide documentation justifying the add-on payment determination, including evidence of at least one qualifying condition (such as severe medical conditions, traumatic brain injury, severe mental/behavioral health conditions, or medically fragile status) and the need for enhanced supports or direct service worker resources.

Defines "waitlisted" as patients no longer requiring acute care but remaining in hospitals because appropriate placement or services cannot be secured, addressing a bottleneck that prevents hospital discharge and delays acute care availability.

Appropriates unspecified general revenue funds for fiscal years 2017-2018 and 2018-2019 to the Department of Human Services to implement medically complex add-on payments.

Effective date is July 1, 2075 (note: this appears to be a typographical error in the bill text).