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US Laws | Affordable Health Care Act (HR3950F)
TITLE II--ROLE OF PUBLIC PROGRAMS
Subtitle C--Medicaid and CHIP Enrollment Simplification

"(5) CONTINUED NEED FOR ASSESSMENT FOR HOME AND COMMUNITY-BASED SERVICES- Nothing in paragraph (1) shall limit or modify the requirement that the State assess an individual for purposes of providing home and community-based services under the State plan or under any waiver of such plan for individuals described in subsection (a)(10)(A)(ii)(VI).". (2501)

SEC. 2202. PERMITTING HOSPITALS TO MAKE PRESUMPTIVE ELIGIBILITY DETERMINATIONS FOR ALL MEDICAID ELIGIBLE POPULATIONS. (2502)(Text)

(a) In General- Section 1902(a)(47) of the Social Security Act (42 U.S.C. 1396a(a)(47)) is amended-- (2503)

(1) by striking "at the option of the State, provide" and inserting "provide-- (2504)

"(A) at the option of the State,"; (2505)

(2) by inserting "and" after the semicolon; and (2506)

(3) by adding at the end the following: (2507)

"(B) that any hospital that is a participating provider under the State plan may elect to be a qualified entity for purposes of determining, on the basis of preliminary information, whether any individual is eligible for medical assistance under the State plan or under a waiver of the plan for purposes of providing the individual with medical assistance during a presumptive eligibility period, in the same manner, and subject to the same requirements, as apply to the State options with respect to populations described in section 1920, 1920A, or 1920B (but without regard to whether the State has elected to provide for a presumptive eligibility period under any such sections), subject to such guidance as the Secretary shall establish;". (2508)

(b) Conforming Amendment- Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 1396b(u)(1)(D)v)) is amended-- (2509)

(1) by striking "or for" and inserting "for"; and (2510)

(2) by inserting before the period at the end the following: ", or for medical assistance provided to an individual during a presumptive eligibility period resulting from a determination of presumptive eligibility made by a hospital that elects under section 1902(a)(47)(B) to be a qualified entity for such purpose". (2511)

(c) Effective Date- The amendments made by this section take effect on January 1, 2014, and apply to services furnished on or after that date. (2512)

Subtitle D--Improvements to Medicaid Services (2513)(Text)

SEC. 2301. COVERAGE FOR FREESTANDING BIRTH CENTER SERVICES. (2514)(Text)

(a) In General- Section 1905 of the Social Security Act (42 U.S.C. 1396d), is amended-- (2515)

(1) in subsection (a)-- (2516)

(A) in paragraph (27), by striking "and" at the end; (2517)

(B) by redesignating paragraph (28) as paragraph (29); and (2518)

(C) by inserting after paragraph (27) the following new paragraph: (2519)

"(28) freestanding birth center services (as defined in subsection (l)(3)(A)) and other ambulatory services that are offered by a freestanding birth center (as defined in subsection (l)(3)(B)) and that are otherwise included in the plan; and"; and (2520)

(2) in subsection (l), by adding at the end the following new paragraph: (2521)

"(3)(A) The term "freestanding birth center services" means services furnished to an individual at a freestanding birth center (as defined in subparagraph (B)) at such center. (2522)

"(B) The term "freestanding birth center" means a health facility-- (2523)

"(i) that is not a hospital; (2524)

"(ii) where childbirth is planned to occur away from the pregnant woman"s residence; (2525)

"(iii) that is licensed or otherwise approved by the State to provide prenatal labor and delivery or postpartum care and other ambulatory services that are included in the plan; and (2526)

"(iv) that complies with such other requirements relating to the health and safety of individuals furnished services by the facility as the State shall establish. (2527)

"(C) A State shall provide separate payments to providers administering prenatal labor and delivery or postpartum care in a freestanding birth center (as defined in subparagraph (B)), such as nurse midwives and other providers of services such as birth attendants recognized under State law, as determined appropriate by the Secretary. For purposes of the preceding sentence, the term "birth attendant" means an individual who is recognized or registered by the State involved to provide health care at childbirth and who provides such care within the scope of practice under which the individual is legally authorized to perform such care under State law (or the State regulatory mechanism provided by State law), regardless of whether the individual is under the supervision of, or associated with, a physician or other health care provider. Nothing in this subparagraph shall be construed as changing State law requirements applicable to a birth attendant.". (2528)

(b) Conforming Amendment- Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)), is amended in the matter preceding clause (i) by striking "and (21)" and inserting ", (21), and (28)". (2529)

(c) Effective Date- (2530)

(1) IN GENERAL- Except as provided in paragraph (2), the amendments made by this section shall take effect on the date of the enactment of this Act and shall apply to services furnished on or after such date. (2531)

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