Maternal and Child Health Act of 1989

Summary

Maternal and Child Health Act of 1989 - Amends title XIX (Medicaid) of the Social Security Act to require States to provide Medicaid coverage to pregnant women and children under age six whose family income is below 185 percent of the Federal poverty level. Authorizes States to provide Medicaid coverage to children under age 19 whose family income is below the Federal poverty level. Directs the Secretary of Health and Human Services to conduct three-year demonstration projects to study the effect on access to health care, private insurance coverage, and health care costs of extending Medicaid coverage in three States to medically uninsurable children and extending such coverage in one State to children under age six whose family income is below 185 percent of the Federal poverty level and children under age 20 whose family income is below the Federal poverty level. Permits such States to provide coverage by buying into the health insurance offered by certain employers. Imposes premiums on project beneficiaries whose family income exceeds the Federal poverty level. Caps project expenditures. Sets forth reporting requirements. Requires States to make Medicaid ambulatory prenatal care available to pregnant women during a presumptive eligibility period. Eliminates the requirement that pregnant women apply for Medicaid coverage within 14 days of the commencement of presumptive eligibility. Requires States to continue the Medicaid coverage of a woman and her infant for 60 days after delivery regardless of fluctuations in her income during such period. Prohibits the redetermination of the Medicaid eligibility of a child under age six who has been deemed eligible less than six months previously, unless such eligibility is due to his or her receipt of aid under part A (Aid to Families with Dependent Children) (AFDC) or E (Foster Care and Adoption Assistance) of title IV of the Act or under title XVI (Supplemental Security Income) (SSI) of the Act. Preserves the Medicaid eligibility of a child under age six who loses such aid until it is determined that he or she is not eligible for Medicaid on some other basis. Amends the Child Support Enforcement Amendments of 1984 to make permanent the four-month continuation of Medicaid eligibility for children who lose AFDC eligibility due to increased collection of child support payments. Requires that Medicaid coverage of inpatient hospital services provided to children under age 18 at hospitals serving a disproportionate share of low-income patients: (1) make an outlier adjustment in payment amounts for exceptionally long or costly cases if such payments are made on a prospective basis; (2) not impose durational limitations on such services; and (3) not set dollar limits on the delivery of services to individuals who enter the hospital prior to their first birthday. Directs States to pay for the care of a child under age 19 in an out-of-State hospital at the receiving State's rate, unless the involved States have an alternative payment agreement. Requires States to provide Medicaid coverage of services furnished by certified pediatric or family nurse practitioners. Permits States to cover home and community-based services for children under age 18 who have acquired immune deficiency syndrome (AIDS) or are medically dependent on a ventilator for life support. Allows States to cover home visitor services furnished by registered nurses to infants, during the first six months of life, who require treatment with life sustaining medication or equipment or technically-assisted feeding. Prohibits the Secretary from limiting to fewer than 500 (currently, 200) the number of individuals in a State who may receive home and community-based services under a waiver of certain Medicaid requirements. Amends title V (Maternal and Child Health Services) of the Act to increase authorized appropriations for such program for FY 1990. Requires the Secretary to set-aside 15 percent of appropriated amounts for special Federal projects which include: (1) projects promoting the use of outpatient and community-based services for children with special health care needs; and (2) demonstration projects utilizing alternative approaches to providing health insurance coverage to children under age 19 who are not covered by other public or private programs. Directs States to use at least 30 percent of their title V allotments on services for children with special health care needs, and at least five percent of such allotments for projects in sickle-cell anemia and genetic disorders screening, the development of community-based service networks and case management services for children with special health care needs, and programs providing primary health care services to children. Requires each State to: (1) conduct a statewide maternal and child health care needs assessment; (2) establish a State maternal child health advisory board to participate in the planning and development of services; (3) develop a system of family centered community-based coordinated care for children with special care needs in collaboration with other programs; (4) develop and maintain a consolidated data base containing information about providers available to meet the needs of chronically ill children and establish a toll-free number for parents to access such information; (5) include in the annual title V report information on the extent to which needs have been met with respect to specific services and the amount of funds allotted for family centered community-based coordinated care; and (6) maintain its title V funding at at least 1989 levels. Amends part A (General Provisions) of title XI of the Act to direct the Secretary to publish an annual report on the health status of U.S. children. Requires the Secretary to make available to States, by January 1, 1991, a model uniform Medicaid application for individuals who are neither institutionalized nor receiving AFDC cash assistance. Directs the Secretary to: (1) develop definitions of medically high risk pregnancy and children at a high risk of medical problems; (2) develop alternative definitions of medically uninsurable children; (3) develop a model health benefit package for pregnant women and children through age 18; and (4) study different methodologies to improve the coordination between various public health programs. Sets forth reporting requirements. Amends the Medicaid program to set forth the required components of Medicaid early and periodic screening, diagnostic, and treatment services. Requires Medicaid coverage of the measures which need to be taken to correct or ameliorate defects or conditions discovered by the screening services. Directs the Secretary to conduct demonstration projects and establish annual participation goals for each State to increase participation in Medicaid early and periodic screening and diagnostic services. Requires the Secretary to report to the Congress by the close of 1990 on the requirements of such services relative to mental illness. Requires States to provide Medicaid coverage to all children under age 18 who are SSI recipients. Requires that Medicaid payment rates for obstetric and pediatric services be set at levels which are sufficient to induce enough providers of such services to participate in the Medicaid program so that such services are available to beneficiaries to at least the same extent that they are available to the general population. Directs States to furnish providers of such services with assistance in complying with Medicaid billing and recordkeeping requirements, which includes: (1) training; (2) a toll-free number for resolving administrative problems; and (3) a State ombudsman for resolving their complaints. Requires the Secretary to report to the Congress by January 1, 1990, on the adequacy and timeliness of Medicaid payments to providers of obstetric and pediatric services. Amends part E (Foster Care and Adoption Assistance) of title IV of the Social Security Act to require that a preplacement health care record for a child be provided to such child's foster care provider and be completed before he or she is placed in foster care or within 30 days after an emergency foster care placement. Requires the maintenance of a health care plan and record for such child while he or she is in foster care, and notification of the provider concerning such child's eligibility for Medicaid early and periodic screening, diagnosis, and treatment services. Amends part A (General Provisions) of title XI of the Act to reduce the lag time between the Secretary's calculation of the Federal matching rate under the AFDC, Medicaid, and Foster Care and Adoption Assistance programs and its implementation.

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2 official files

• Introduced in Senate (text)

  Introduced in Senate · EN

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• Introduced in Senate

  summary · EN · 19 June 1989

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