To temporarily exclude certain Medicaid services from the statewide managed care system and to develop a plan for future integration.
Key Provisions
Temporary Exclusion from Managed Care
Until July 1, 2026, the following services are excluded from the statewide Medicaid managed care program:
Services for Medicaid members in Qualified Residential Treatment Programs (QRTPs)
Services for Medicaid members in Psychiatric Residential Treatment Facilities (PRTFs)
Applies only to children/youth in the custody of a county department of human or social services
Policy Development Requirement
By December 1, 2025, the Department of Health Care Policy and Financing (HCPF), in coordination with:
Department of Human Services
Behavioral Health Administration
Other relevant stakeholders
Must develop policies for how these residential services will be transitioned into the statewide managed care system
Implementation Deadline
These transition policies must be implemented by July 1, 2026
Overall Effect
Delays integration of certain high-needs Medicaid youth services into managed care.
Allows time to collaboratively design policies that ensure safe and effective transition into the broader system.
Aims to protect vulnerable children during a period of structural change in Medicaid service delivery.
Summary
Joint Budget Committee. The bill excludes from the statewide
managed care program the services delivered to medicaid members who are in a qualified residential treatment program or a psychiatric residential treatment facility and in the care and custody of a county department of human or social services until July 1, 2026. No later than December 1, 2025, the bill requires the department
of health care policy and financing (HCPF), in collaboration with the department of human services, the behavioral health administration, and relevant stakeholders, to develop policies to transition qualified residential treatment programs and psychiatric residential treatment facilities to the statewide managed care system for medicaid members who are in the care and custody of a county department of human or social services (policies). No later than July 1, 2026, the bill requires HCPF to implement the policies.
