House
File
2501
H-8496
Amend
House
File
2501
as
follows:
1
1.
Page
111,
after
line
12
by
inserting:
2
<
DIVISION
___
3
MEDICAID
REIMBURSEMENT
POLICIES
FOR
INPATIENT
CARE
4
Sec.
___.
MEDICAID
REIMBURSEMENT
POLICIES.
5
1.
The
department
of
human
services
shall
amend
441
IAC
6
79.1(5)(g)(5)
relating
to
the
billing
for
patient
transfers
7
and
readmissions
for
inpatient
readmissions
within
30
days
for
8
the
same
condition,
to
define
“same
condition”
as
the
same
9
Medicare
severity
diagnosis
related
groups
(MS-DRG)
code.
10
Planned
admissions
for
conditions
including
but
not
limited
11
to
transplant,
dialysis,
pregnancy,
rehabilitation
care,
and
12
chemotherapy
shall
be
excluded
from
this
reimbursement
policy.
13
2.
If
a
Medicaid
member
is
enrolled
with
a
managed
care
14
organization
or
changes
the
member’s
managed
care
organization
15
at
any
point
during
an
inpatient
stay,
the
managed
care
16
organization
effective
at
admission
is
responsible
for
the
17
reimbursement
for
the
admission,
not
to
exceed
60
calendar
days
18
after
disenrollment
of
the
member.
19
Sec.
___.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
20
deemed
of
immediate
importance,
takes
effect
upon
enactment.
21
Sec.
___.
RETROACTIVE
APPLICABILITY.
This
division
of
this
22
Act
applies
retroactively
to
April
1,
2016.
>
23
2.
By
renumbering
as
necessary.
24
______________________________
WESSEL-KROESCHELL
of
Story
-1-
HF2501.5739
(3)
87
pf/rn
1/
1
#1.
#2.