Senate Bill 594 Summary

• Excludes individuals receiving COVID-19 testing coverage from Medicaid managed care and repeals temporary provider changes implemented during the public health emergency, effective 30 days after enactment.

• Allows Medicaid beneficiaries to file appeals by telephone in addition to mail or fax, and establishes expedited appeal processes when delays could jeopardize a recipient's life, health, or ability to attain maximum function.

• Increases allowable therapeutic leave from 60 to 90 days annually for beneficiaries in intermediate care facilities and maintains 60 days for skilled nursing facilities, with a maximum of 15 consecutive days without departmental approval.

• Authorizes coverage of behavioral health services for populations excluded from prepaid health plan coverage through BH IDD tailored plans and allows area authorities to dissolve with fund balance transfers to continuing authorities.

• Extends the durable medical equipment rate floor from three to five years, clarifies behavioral health service definitions in standard benefit plans, and makes various technical corrections to Medicaid statutes.