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CMS offers guidance to help connect children to Medicaid services


The U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, has released guidance on a new Medicaid health home benefit for children with medically complex conditions.

The new optional benefit helps state Medicaid programs provide Medicaid-eligible children who have medically complex conditions with person-centered care management, care coordination, and patient and family support. CMS anticipates the new benefit will help these children receive care even across state lines.

Children with medically complex conditions – including serious health concerns like cerebral palsy, cystic fibrosis, blood diseases, and mental health conditions that can severely impact a child’s ability to function – often require tremendous care coordination and highly specialized treatment, said CMS.

Finding needed services often requires traveling beyond a family’s home, and often care is only available for these children out-of-state. The new health home services are expected to give these children and their families help in coordinating and managing care.


As outlined in a letter to state Medicaid directors, states will have the option to offer the new health home services benefit beginning October 1. The services provided under the new benefit include providing access to the full range of pediatric specialty and […]

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