Reporting Requirements--Medicaid, 2007 Operating Budget

Medical Day Care Centers -- Access to Services

Language was written into the Medicaid budget requiring the Deparment of Health and Mental Hygiene (DHMH) to report on the use of medical day services. The report should contain the following data:

• Numbers of applicants and recipients of services who are denied initial admission or continuing eligibility;
• Initial (or continuing stay) denials that affect individuals with psychiatric conditions, developmental disabilities, or brain injuries;
• Appeals or outcomes of those appeals; and
• Individuals who were initially denied but received services at another care site (e.g., nursing home, medical day provider, inpatient hospital stay, or other agency).

This report should cover the the time period from October 2005 through September 1, 2006.

Nursing Homes--Quality Measures

The budget restricts $2.5 million to nursing homes pending a joint (Health Facilities Association of Maryland and Mid-Atlantic Life Span) proposal for using the nursing home payment formula to link payment with nursing home quality. Another $100,000 has been restricted to DHMH to produce a similar proposal as well as developing a timetable for implementation plan.

The Conference Committee report states that If these two plans should differ, the report should explain the underlying reasons for the differences.