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S 669

Requires a traffic study as part of an application to establish a charter school

2025 Regular Session Introduced by Robert Jackson

Extends the COVID telehealth per‑diem rate for partial‑care behavioral health/SUD services for 180 days post‑waiver and requires coverage without prior authorization.

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Bill Summary · S 669

Summary — S 669: Extension of COVID-19 Medicaid per‑diem rate and Medicaid coverage for partial‑care behavioral health and SUD services

Status: Introduced in Senate; referred to committee (materials show state-level versions and related actions). Introduced: February 20, 2025. Subject: Medicaid.

Note on source materials: The packet provided includes multiple, partly inconsistent texts from different jurisdictions (a Massachusetts land‑conservation draft and a New Jersey‑style Medicaid bill). The summary below focuses on the Medicaid bill text included in the materials (the provisions extending telehealth per‑diem reimbursement and removing prior authorization for partial‑care behavioral health and substance use disorder (SUD) services).

Purpose / Intent

To maintain Medicaid reimbursement and streamline coverage policies adopted during the COVID‑19 emergency for "partial care" behavioral health and SUD treatment programs by:
- Extending the telehealth per‑diem reimbursement rate for a transitional period after the federal waiver ends, and
- Requiring Medicaid coverage of partial‑care services up to defined hourly limits without prior authorization or other utilization management.

The intent is to stabilize provider cash flow, preserve access to community‑based care delivered by telehealth during the transition back to in‑person services, and reduce administrative barriers.

Key provisions

  • Definitions:
    • “Partial care services” — structured, non‑residential behavioral health or SUD services for adults with severe mental illness or SUD (examples: psychiatric care, individual/group counseling, case management, prevocational services).
    • “Per diem rate” — the daily telehealth reimbursement rate established during the COVID‑19 emergency (defined as equal to the reimbursement for 5 hours of in‑person services).
  • Reimbursement extension:
    • The Division of Medical Assistance and Health Services must reimburse partial‑care providers at the emergency telehealth per‑diem rate for 180 days after the federal Medicaid waiver authorizing that rate expires.
    • Telehealth claims under this provision are reimbursed without prior authorization or other utilization management.
    • The bill text cites current per‑diem amounts used during the pandemic: $89.60/day for partial‑care behavioral health telemedicine and $78.31/day for partial‑care SUD telemedicine.
  • Provider requirements and reporting:
    • Providers must be open for onsite services.
    • Providers must submit status reports on day 90, day 150, and day 180 of the 180‑day period with: total patients served, number receiving in‑person services, and nature of in‑person services.
    • The Division will use reports to assess whether to extend the per‑diem beyond 180 days. A decision to extend must be made at least 20 days before the 180‑day period ends. If extended, providers submit status reports every 60 days during the extension.
  • Coverage without prior authorization:
    • Division must provide Medicaid coverage of partial‑care services on an hourly basis up to 5 hours/day, 5 days/week, without prior authorization or other utilization management requirements (a permanent policy in the bill).
  • Administrative steps:
    • The Commissioner must apply for any State Plan Amendments or waivers needed to secure federal financial participation and adopt regulations under the Administrative Procedure Act.
  • Effective date: immediate upon enactment.

Who is affected

  • Medicaid beneficiaries with severe mental illness or substance use disorder who receive partial‑care services.
  • Partial‑care providers (community behavioral health and SUD programs) — financial and reporting implications.
  • State Medicaid program administrators responsible for implementing reimbursement and regulatory changes.

Timeline and procedural notes

  • The core transitional extension runs for 180 days after the federal waiver ends; extension decisions must be made ≥20 days before the period ends.
  • Providers must file reports at specified days (90, 150, 180) and every 60 days if extended.
  • Implementation requires State Plan changes/waivers to secure federal matching funds.

Potential impacts

  • Short‑term provider cash‑flow stabilization and reduced administrative burden from prior‑authorization elimination.
  • Facilitates continued telehealth access while encouraging gradual restoration of in‑person services (via reporting requirements).
  • Fiscal impact depends on utilization and federal approval of State Plan amendments/waivers; removing prior authorization could increase service uptake and costs unless offset by federal match or other program controls.

If you want, I can produce a concise one‑page fact sheet for providers, a timeline graphic of reporting and decision points, or a redline comparison to current Division policies.

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

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