Concurrent Care for Children
To: NHPCO Members
From: NHPCO Regulatory Team
Re: September 10, 2010
Concurrent Care for Children
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Summary at a Glance: CMS has issued a State Medicaid Director Letter giving guidance to the states about the implementation of the new provision in Medicaid and CHIP that allows children who have elected the hospice benefit to continue to receive all other services for which the child is eligible. States will each implement the provision according to the guidance in the letter. This provision is the result of a section of Affordable Care Act. |
On Thursday, September 09, 2010, CMS released a State Medicaid Director Letter announcing the details for implementation of Section 2302 of the Patient Protection and Affordable Care Act, entitled “Concurrent Care for Children.”
Provisions
This provision allows for children covered under either Medicaid or the Medicaid expansion Children’s Health Insurance Program (CHIP) to receive both hospice services and curative treatment upon the election of the hospice benefit “by or on behalf of a Medicaid or Children’s Health Insurance Program (CHIP) eligible child.”
- The Patient Protection and Affordable Care Act, does not change the criteria for receiving hospice services.In order to qualify for the hospice service in either Medicaid or CHIP, a physician must certify that the eligible person is within the last 6 months of life.
- The ACA requires States to make hospice services available without forgoing any other services for which the child is eligible.The services may include pain and symptom management, family counseling and other services, which are not specified in this letter.
Implementation
This provision became effective when the ACA was signed into law on March 23, 2010. CMS expects States to begin providing this concurrent coverage immediately and will provide States with the appropriate forms and language for any revisions to the State Medicaid Plan.
This letter should be seen as a “first step” in the implementation of the Concurrent Care for Children provision. By releasing this transmission to the states, CMS has merely begun a process of dialogue on the provision and will now have more flexibility to field questions from stakeholders.
NHPCO’s Pediatric Policy State Leaders Networking Group
A number of states have established strong coalitions in support of pediatric palliative and hospice care and/or state policy initiatives to provide concurrent care for children with life-threatening conditions. NHPCO has convened this network of state leaders, called the Pediatric Policy State Leaders Networking Group, to share successes, resources, and advocacy tips for advancing pediatric policy initiatives at the state level.
Rest assured, NHPCO , in close coordination with this group, has been and will continue to examine and analyze all information regarding the new section of the ACA and the State Medicaid Director Letter, as it applies to pediatric hospice and palliative care, and will be providing additional guidance and resources to our members. We also expect to have additional opportunities to ask specific questions to CMS regarding implementation and billing for this provision. If you would like to submit specific questions, please send an email to regulatory@nhpco.org and put “Concurrent Care for Children” in the subject line.
