The Affordable Care Act (ACA) Changes Care for Pediatric Palliative Care Patients
For many years, healthcare professionals and families with children living with life-limiting or life-threating conditions had few options for Medicaid coverage when children were very serously ill. Parents in all but a few states were faced with forgoing curative treatments for their children to be eligible for hospice services, or conversely, they were not eligible for beneficial interdisciplinary hospice services while getting curative treatment.
The Patient Protection and Afordable Care Act changed that situtiton. It requires all state Medicaid programs to pay for both curative and hospice services for children under age 21 who qualify. On March 23, 2010, President Obama signed ACA into law enacting a new provision, Section 2302, termed the “Concurrent Care for Children” Requirement (CCCR).
Section 2302 states that a child who is eligible for and receives hospice care must also have all other services provided, or have payment made for, services that are related to the treatment of the child’s condition. This provision affects children who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP). In its simplest form, implementation of this provision could be accomplished by the state Medicaid agency eliminating any provider claims that deny or delay concurrent curative care and hsopice claims.
– excerpt from Pediatric Concurrent Care – Continuum Briefing (January 2013) – The Mary J. Labyak Institute for Innovation at the National Center for Care at the End of Life. Click on link for full article.
In the News
“Lawmakers Look to Improve Care for Kids with Complex Needs” – Published January 2015 – The following link highlights an article about a proposed care coordination bill in Congress, Advancing Care for Exceptional Kids Act. Lawmakers Look to Improve Care for Kids with Complex Needs
“Mother Advocates for More Palliative Care in Pennsylvania After Daughter Benefits During Battle with Cancer” – Published May 2014 – The following link highlights a family affected by pediatric cancer and the importance of palliative care and, therefore, Senate Bill 453. Lewisburg Mom Travels to State Capitol to Share Memories of Daughter