hb279_LC_37_0381S_hcs

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07 LC 37 0381S

House Bill 279 (COMMITTEE SUBSTITUTE)

By: Representatives Collins of the 27th, Cooper of the 41st, Burkhalter of the 50th, Lunsford of the 110th, Ralston of the 7th, and others

A BILL TO BE ENTITLED
AN ACT

To amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally, so as to require certain procedures for determinations relating to eligibility for medical assistance through the Katie Beckett waiver program for children with Spina Bifida who have Myelomeningocele; to make a statement of legislative findings; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally, is amended by inserting a new Code section to read as follows:

"49-4-153.1.

(a) The General Assembly finds that this Code section meets the nursing facility level of care criteria.

(b) A minor child with Spina Bifida who has Myelomeningocele and is otherwise eligible for medical assistance under the state plan provided pursuant to this article through the waiver programs created under the Tax Equity and Fiscal Responsibility Act of 1982, commonly referred to as Katie Beckett waivers, shall qualify for such waiver if the child:

(1) Is born with Meningomyelocele, the most severe form of Spina Bifida, for one year after birth as these children will require some surgical correction on the spine, most will require shunting, and complications from shunting will usually occur in the first year; or

(2) After the first year of birth has at least three of the following as defined by the department:

(A) Shunted hydrocephalus;

(B) Neurogenic bladder/bowel;

(D) Mental issues or learning disabilities which shall be evidenced by documentation that may include, but shall not be limited to, a formal individualized education program (IEP) or its equivalent; or

(E) Rehabilitation needs or therapeutic activities or exercises which shall be furnished directly by or under the supervision of technical or professional personnel no less than twice per month; or

(3) After the first year of birth, three or more hospitalizations for Spina Bifida related problems including, but not limited to, shunt malfunction, urosepsis, orthopedic surgeries, or urological surgeries.

(c) Once the above eligibility for this waiver is documented, the department shall not be authorized to require further physician certification or documentation for purposes of eligibility under this waiver program. However, a physician letter shall be provided annually indicating eligibility conditions and such letter shall serve as adequate continued eligibility documentation under this waiver program."

SECTION 2.

All laws and parts of laws in conflict with this Act are repealed.