Senate Bill 2386 - Medicaid Amendments

• Expands Medicaid eligibility for children in foster care to age 26 (previously 21) and adds men of reproductive age to family planning services at 194% of federal poverty level.

• Requires Division of Medicaid to submit waiver by July 1, 2025 for less frequent medical redeterminations for eligible children with long-term chronic conditions and eliminates requirement to apply for waivers for end-stage renal disease, cancer, and organ transplant patients.

• Updates reimbursement rates and services including: eyeglasses every 2 years (instead of 5), pediatrician services at 100% Medicare rate, twelve-month oral contraceptive supplies, autism spectrum disorder services, preparticipation physical evaluations, and FDA-approved medications for chronic weight management and cardiovascular disease prevention.

• Authorizes Ambulatory Surgical Centers reimbursement at 90% of Medicare ASC rate, establishes quality-based component option for nursing facilities, and reimbursement for snoring/sleep apnea devices and certified community behavioral health centers.

• Reduces legislative notice requirement for Medicaid rate changes and State Plan Amendments from 30 days to 15 days (when possible) with expedited notification option; extends border city pediatric hospital services to July 1, 2027 and ambulance services to July 1, 2029; bans Medicaid coverage for gender transition procedures for any person.