[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3486 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 3486

  To protect previously approved State Medicaid plans from changes in 
Federal payment for school-based health services for Medicaid-eligible 
            children with individualized education programs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 18, 1999

 Mr. Moran of Kansas introduced the following bill; which was referred 
                      to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
  To protect previously approved State Medicaid plans from changes in 
Federal payment for school-based health services for Medicaid-eligible 
            children with individualized education programs.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. REIMBURSEMENTS FOR SCHOOL-BASED HEALTH SERVICES UNDER 
              MEDICAID.

    (a) In General.--With respect to regulations established by the 
Health Care Financing Administration making changes to the HCFA policy 
under the medicaid program regarding the use of a bundled rate to pay 
for medical services provided to medicaid-eligible children with 
individualized education programs, any State that has a rate 
methodology and documentation system previously approved by HCFA for 
such services shall be deemed to be in compliance with such regulations 
with respect to rate, payment, and reconciliation procedures if the 
rate methodology and documentation system is described in subsection 
(b).
    (b) Methodology and Documentation System.--A rate methodology and 
documentation system is described in this subsection if the system, 
with regard to local educational agencies that serve children described 
in subsection (a)--
            (1) includes case rates based on--
                    (A) retrospective analysis of actual costs, 
                adjusted every three years, and
                    (B) the type, amount, duration, and scope of 
                medicaid-eligible services actually provided to each 
                eligible child on a periodic basis;
            (2) includes documentation of the type, amount, duration, 
        and scope of medicaid-eligible services--
                    (A) provided to each such child on a periodic 
                basis, and
                    (B) documented in the care instruction in each 
                individualized education program; and
            (3) permits reconciliation using the documentation 
        described in paragraph (2).
    (c) Definitions.--For purposes of this section:
            (1) HCFA.--The term ``HCFA'' means the Health Care 
        Financing Administration.
            (2) Medicaid program.--The term ``medicaid program'' means 
        the program under title XIX of the Social Security Act.
            (3) State.--The term ``State'' has the meaning given such 
        term for purposes of the medicaid program.
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