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Bill Summary · HB 6937

Bill Summary — HB 6937

Title: AN ACT CONCERNING MEDICAID COVERAGE FOR MEDICALLY NECESSARY CHILDREN'S DIAPERS
Bill Number: HB 6937
Introduced: February 13, 2025
Current Status: Referred by House to Committee on Appropriations (04/29/2025)
Subject Areas: Children, Diapers, Medicaid, Medical necessity, Social Services, Department of Social Services

Purpose / Intent

The stated intent of HB 6937 (per the title) is to require Medicaid coverage for "medically necessary children's diapers." The bill aims to ensure that children enrolled in Medicaid who require diapers due to a medical condition have those supplies covered as a benefit, reducing out-of-pocket costs for families and improving access to required medical supplies.

Key provisions (based on title and typical legislative approach)

The bill text is not included in the provided materials. Based on the bill title and common legislative practice for similar measures, HB 6937 would likely do one or more of the following:

  • Direct the Department of Social Services (DSS) to provide Medicaid coverage for diapers (or incontinence supplies) for children when prescribed or certified as medically necessary by a licensed provider.
  • Define or establish criteria for "medical necessity" for children's diapers (for example, diagnoses, duration, or documentation requirements).
  • Specify which Medicaid populations are eligible (e.g., children under a certain age, children in fee-for-service vs. managed care).
  • Set procedures for claims, prior authorization, durable medical equipment/supply coding, and provider reimbursement.
  • Identify an effective date and any required rulemaking or implementation steps for the DSS.

Note: Exact statutory language, definitions, reimbursement rates, and eligibility details are not available in the provided record and must be confirmed by reviewing the bill text and committee analyses.

Who would be affected

  • Children enrolled in Medicaid who require diapers due to medical conditions (and their families/caregivers).
  • Health care providers and suppliers who furnish diapers and related incontinence supplies.
  • The Department of Social Services and Medicaid program administrators (policy, billing, and compliance functions).
  • State budget/appropriations — potential fiscal impact on Medicaid expenditures.

Fiscal & implementation considerations

  • Coverage could increase Medicaid program costs depending on eligibility criteria, utilization, and reimbursement rates.
  • The Appropriations Committee referral indicates anticipated budgetary review; the Office of Fiscal Analysis (OFA) and Office of Legislative Research (OLR) may prepare fiscal and policy analyses (a referral to those offices occurred on 03/11/25).
  • Implementation would require administrative actions (eligibility rules, billing codes, provider guidance) by DSS.

Legislative timeline / status

  • 02/13/2025 — Referred to Joint Committee on Human Services
  • 02/27/2025 — Public hearing held
  • 03/05/2025 — Joint favorable report; filed with LCO
  • 03/11/2025 — Referred to OLR and OFA for analysis (03/17/25)
  • 03/18/2025 — Favorable report out of committee; tabled for House calendar (House calendar number 99; File No. 114)
  • 04/29/2025 — Referred by House to Committee on Appropriations (current status)

Next steps / How to follow

  • Obtain the bill text and committee report from the Legislative Commissioners’ Office (LCO) or the General Assembly website for exact provisions.
  • Review the OFA fiscal note and OLR report for estimated cost and policy analysis once available.
  • Monitor the Appropriations Committee for hearings, testimony, and any proposed amendments.

If you want, I can retrieve the bill text (if available online) and prepare a more detailed provision-by-provision summary and a likely fiscal impact estimate.

Compiled from official sources — confirm details with the bill’s official record.

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