Charles Bruner, executive director of the Child and Family Policy Center and presenter at the 2013 Help Me Grow National Forum, has prepared a three-page summary that covers the existing and potential opportunities for Medicaid financing for Help Me Grow. This summary includes salient information from his 2013 Forum presentation, “Policy Implications.”
“Given the different structures of state Medicaid programs, there is no one way to modify state Medicaid reimbursement systems to secure Medicaid financing for Help Me Grow,” Bruner writes. “Instead, there are different options that states can pursue and that have precedent within prior approvals of state plan amendments or Centers for Medicaid and Medicare Services (CMS) guidance.”
The summary details the Help Me Grow services that can and should be covered by Medicaid, including developmental surveillance and screening; the training and support to enable child health practitioners to do that surveillance and screening; care coordination provided as a result of practitioner referrals; community health liaison work that makes that care coordination effective; and some of the services to which families and children are referred, when they meet state definitions of ‘medical necessity.’
The summary also includes a case example regarding Help Me Grow-type programs posed to CMS and the CMS response; a look at the current situation regarding Medicaid reimbursement; and a rundown on questions regarding Medicaid reimbursement.