S. 1217 would amend title XIX of the Social Security Act to improve and protect rehabilitative services and case management services provided under Medicaid to improve the health and welfare of the nation's most vulnerable seniors and children.
Detailed Summary
Medicaid Services Restoration Act of 2009 - Amends title XIX (Medicaid) of the Social Security Act to extend medical assistance coverage to therapeutic foster care services.
Allows reasonable and efficient payment methodologies, including fee-for-service payments, case rates, daily rates, or other forms of capitated payment, as means of reimbursement for rehabilitative services.
Includes medical or remedial services for attainment and retention of functional status among rehabilitative services.
Includes among inpatient psychiatric hospital services for children early and periodic screening, diagnostic, and treatment services.
Allows payment for medical assistance for diagnostic, screening, preventive, and rehabilitative services or optional targeted case management services furnished by qualified providers under non-medical programs, provided a state or local agency administering such plan complies with certain requirements.
Allows reasonable and efficient payment methodologies for reimbursement for case management and targeted case management services.
Authorizes the state to: (1) require case management services for each beneficiary; and (2) limit the case managers available in order to ensure that the case managers for eligible individuals are capable of ensuring that such individuals receive needed services. Allows staff of non-medical programs, or contractors with non-medical programs, to offer such services, so long as: (1) such individuals are state-qualified providers; and (2) the case management services are distinct from the non-medical program's direct services.
Redefines case management services to mean those furnished to assist eligible individuals, who reside in a community setting or are transitioning to a community setting, in gaining access to needed medical, social, educational, and other services.
Allows a state to provide case management or targeted case management services through multiple case managers to: (1) any qualified individual; (2) specific classes of individuals; or (3) individuals who reside in specified areas selected by the state.
Status of the Legislation
Latest Major Action: 6/9/2009: Referred to Senate committee. Status: Read twice and referred to the Committee on Finance.
Points in Favor
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Points Against
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Visitor Comments
John Connery
July 21, 2009, 3:36pm (report abuse)S 1217 Will continue support for special needs children to remain in Therapeutic Foster Care and will help save money long term as fewer children will be admitted to psychiatric hospitals. Some research has suggested that they will stand a better chance of becoming productive members of our society after living with a Therpaeutic Foster family.
We need a companion House Bill now.