Protect Brain Injury Care Access

What's happening

Why it matters

1. 1

   Protects vulnerable populations. by ensuring that people with traumatic brain injuries (TBI) or those eligible for nursing home diversion/transition services continue to receive specialized care outside of managed care plans, which may not have the expertise or flexibility to meet their complex needs.

2. 2

   Requires ongoing state action. by directing the Commissioner of Health to actively seek federal waivers or extensions as needed, guaranteeing that these services remain available outside managed care and are not inadvertently disrupted by federal or administrative changes.

3. 3

   Removes planned transition to managed care. for these populations by deleting the previous sunset date, making this exemption indefinite instead of temporary, which provides greater stability and predictability for recipients and their families.

Who cares

• Medicaid recipients with traumatic brain injuries

  The bill would remove the January 1, 2022 limit on keeping their waiver services outside managed care programs established under this section.

• Medicaid recipients qualifying for nursing home diversion and transition services

  Their waiver services would likewise remain outside those managed care programs without the specified cutoff date.

• New York State Department of Health

  The health commissioner would be directed to take necessary steps, including federal waiver and waiver-extension filings, to continue these services.

• Medicaid managed care plans

  The bill would continue excluding these waiver services from their programs under this section, subject to the section’s expiration and repeal.

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History

Companion bill

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