House Bill 1026 - Medicaid Technical Amendments

• Extends Medicaid eligibility to age 26 for children in state custody who are in foster care on their 18th birthday, and for children who aged out of foster care while on Medicaid in other states.

• Authorizes contraceptives to be prescribed and dispensed in 12-month supply increments under family planning services and allows the family planning waiver program to operate under a waiver or state plan.

• Expands ambulance service reimbursement to include assessment, triage, treatment, and transport to alternative destinations (urgent care, federally qualified health clinics, behavioral health facilities) as determined by the Division of Medicaid.

• Requires supplemental hospital payments not decrease by more than 5% compared to prior year and prohibits substantial changes to hospital payment calculation methodologies; requires state-owned acute care hospitals to submit intergovernmental transfers for their supplemental payments.

• Requires third-party payors to accept prior authorization from the Division of Medicaid that an item or service is covered under the state plan, treating it as valid prior authorization from the payor.