H.F. 5124 Summary

• Modifies Medical Assistance payment rates for Indian health services facilities that purchase drugs through the Federal Supply Schedule (FSS), allowing reimbursement at FSS actual acquisition cost plus professional dispensing fee when actual acquisition cost exceeds the standard rate.

• Allows Indian health services facilities to submit FSS rates with basis of cost indicator "08" and permits written protocols for calculating FSS actual acquisition drug costs based on monthly, quarterly, or other averages without including inflation, markup, spread, or margin.

• Modifies Medical Assistance payment rates for Indian health services facilities using the federal 340B Drug Pricing Program, allowing reimbursement at the 340B rate with basis of cost indicator "08" and submission clarification code "20" when actual acquisition cost exceeds the standard rate.

• Changes hospital accreditation requirement for adult day treatment providers by removing the specific requirement that hospitals be "accredited by the Joint Commission on Accreditation of Health Organizations," simplifying the eligibility criteria for hospitals to serve as adult day treatment providers.

• Maintains existing requirements for adult day treatment services including multidisciplinary team provision, minimum two days per week availability, at least one hour of group psychotherapy, and client eligibility criteria including age 18 or older and mental health professional recommendation.