HB 7 — AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO PEDIATRIC INPATIENT BEHAVIORAL HEALTH ENHANCEMENT.

Summary

This Act requires Delaware Medicaid to provide an enhancement to the acute care per diem rate for psychiatric facilities for hard to place pediatric behavioral health inpatients. The per diem enhancement is limited to an inpatient stay of 14 days. The applicability of the per diem enhancement is determined based on whether admission criteria is met. This Act also creates a Quality Oversight Committee designed to identify quality metrics for facilities admitting patients as well as provide biennial recommendations to the General Assembly’s Joint Finance Committee regarding eligibility categories and enhancement rates.

Bill Text

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This bill amends Delaware law to enhance the per diem rate for Medicaid reimbursement to psychiatric facilities for specific pediatric inpatient cases and establishes a Quality Oversight Committee.

• Chapter 5, Title 31

  § 532. Pediatric Inpatient Behavioral Health Enhancement.

  This introduces a new section for pediatric inpatient behavioral health enhancement.

• § 532(b)

  A carrier must pay an enhanced per diem rate to any facility that admits a patient, 18 years old or younger, who meets at least 1 of the following criteria: ...

  This mandates that carriers pay enhanced rates for specific pediatric admissions.

• § 532(c)

  A carrier’s enhanced per diem rate, for a patient who meets any of the criteria under subsection (b) of this section, must be at least 30% more than the ordinary per diem rate.

  This stipulates a minimum increase of 30% over the ordinary per diem rate for qualifying patients.

• § 532(d)

  A carrier must increase an enhanced per diem rate, as determined under subsection (c) of this section, by at least 5% for every inpatient day that is a Saturday or Sunday.

  This requires extra compensation for weekend inpatient days.

• § 532(e)

  A carrier must limit the number of days eligible for an enhanced per diem rate to 14 days.

  This limits the duration for which enhanced per diem rates can be applied.

• § 532(f)

  The Department shall form a Quality Oversight Committee to identify quality metrics for facilities admitting patients 18 years or younger.

  This establishes a Quality Oversight Committee to oversee and improve care quality in pediatric facilities.

• § 532(f)(2)

  The Quality Oversight Committee shall review the enhanced per diem rate established under this section and shall biennially make recommendations to the General Assembly’s Joint Finance Committee regarding eligibility categories and enhancement rates.

  This mandates regular reviews and recommendations for enhancement rates by the committee.

Action History

1. March 05, 2024

   Stricken in House

2. April 25, 2023

   Introduced and Assigned to Health & Human Development Committee in House

Sponsors

• Stell Parker Selby · Primary
• Valerie Longhurst · Primary
• Laura V. Sturgeon · Primary
• Kendra Johnson · Primary
• Sarah McBride · Primary
• Eric Morrison · Primary
• David P. Sokola · Primary
• Spiros Mantzavinos · Primary
• Nicole Poore · Primary
• Michael F. Smith · Primary
• Trey Paradee · Primary
• Russell Huxtable · Primary
• Sean Matthews · Primary
• Peter C. Schwartzkopf · Primary
• Ruth Briggs King · Primary

Subjects