Medicaid Access Improvement Amendments of 1990

Summary

Medicaid Access Improvement Amendments of 1990 - Amends title XIX (Medicaid) of the Social Security Act to require States to provide for the receipt and initial processing of Medicaid applications at locations other than those used for the receipt and processing of applications for Aid to Families with Dependent Children under part A of title IV such as hospitals or clinics providing covered services to Medicaid applicants. Prohibits States from discontinuing a child's Medicaid benefits until it is determined that the child is not eligible for such benefits on any basis. Prohibits the application of fixed durational limits to medically necessary inpatient hospital services for all Medicaid-eligible individuals regardless of age. Prohibits aggregate or institutional volume caps which would limit medically necessary days or result in arbitrary reductions in established payment rates for days exceeding such caps. Prohibits the waiver of such prohibitions to promote cost-effectiveness and efficiency. Requires outlier adjustments under State prospective payment plans for medically necessary inpatient hospital services for very high cost or exceptionally lengthy cases regardless of the age of the Medicaid-eligible patient. Allows State flexibility in setting adjustments for different types of disproportionate share providers. Prohibits application of visit limits to medically necessary covered outpatient services provided to individuals in disproportionate share hospitals as defined by the States under current law for inpatient payment adjustment. Requires States to adjust payments for outpatient services provided to individuals by disproportionate share hospitals. Prohibits the waiver of such provisions to promote cost-effectiveness and efficiency.

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2 official files

• Introduced in House (text)

  Introduced in House · EN

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• Introduced in House

  summary · EN · 22 October 1990

  Open at official source

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