CMS Guides U.S. States on New Benefit to Improve Access to Care for Children With Complex Medical Conditions
A new Medicaid health home benefit (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html) could improve access to person-centered care management, care coordination, and support resources for children with complex medical conditions and their families—but only if states understand how to opt into offering it. In August 2022, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), released (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html) guidelines for states to better understand the benefit (https://www.medicaid.gov/federal-policy-guidance/downloads/smd22004.pdf) and its requirements.
"CMS and our state partners are doing all that we can to provide whole-person care through Medicaid and the Children's Health Insurance Program," Chiquita Brooks-LaSure, CMS administrator, said (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html). "The new state plan option is about ensuring that children and families can get coordinated, high-quality care—particularly children with complex medical conditions. CMS is committed to working with states interested in pursuing this option to ensure they can quickly and efficiently get kids the care they need."
Children with complex conditions like cancer can require specialized treatment plan (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html)s, HHS explained, and the new services will help the families and providers better coordinate and manage their care (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html).
"Every child deserves the care and support they need to stay healthy and thrive,” Xavier Becerra, HHS secretary, said (https://www.hhs.gov/about/news/2022/08/01/cms-offers-roadmap-for-states-to-help-connect-children-with-complex-medical-conditions-to-critical-medicaid-services.html). “The new Medicaid health home benefit will give states new options and financial incentive to improve care for children with complex medical conditions. At HHS, we are committed to providing families with access to appropriate pediatric specialty and subspecialty medical services, including when those services are needed across state lines.”