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Pediatric Palliative Care

Next Reply: Re:Concurrent Care for Children Requirement
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Post Concurrent Care for Children Requirement
Author: bassriley
Date: Apr 20, 2011 8:27 am
Hi everyone,

I'm new to this forum, so I apologize if this topic has already been covered.

The health reform law has a provision (the Concurrent Care for Children Requirement-CCCR) that mandate that Medicaid or state CHIP programs provide both curative care and hospice care for pediatric patients. The CCCR also allows states to expand this coverage to include pediatric palliative care programs that provide coverage beyond the 6 month prognosis requirement for hospice admission.

Do any of you have any knowledge of states that have expanded their Medicaid or CHIP coverage to include pediatric palliative care concurrent with curative care as a result of the CCCR? Or do any of you know of any state level advocacy that is being done to expand this coverage?

Thanks,

Bryan Bass-Riley
Nemours-Alfred I duPont Hospital for Children
Wilmington, DE
Replies: order by [Date] [Author] [Subject]
Re:Concurrent Care for Children Requirement (by StacyRemke on 04/20/2011)
Hi Bryan. This is a topic that is important, and yet there aren't very clear answers yet. There is a group that has been tracking this issue across various states through NHPCO. If you haven't already seen them, please check out the CCCR tools at the NHPCO website: www.nhpco.org/pediatrics
These may help you figure out how to proceed in your state. Florida and California and a few other states have been piloting models for a while. Other states are in various stages of development. Here in MN, for example, we recently determined we probably need to identify appropriate people in our state DHS office to dialog with and to present cases to, so they start to feel a bit of pressure to come up with plans. Our sense is that we need to draw their attention to the issue in this climate of many competing pressures on our state administration. You may want to identify other stakeholders in your state, and then identify some key people at your state offices who will engage in planning with you. Hope that helps!
Re:Concurrent Care for Children Requirement (by shuff2 on 04/21/2011)
In Maryland,so far they are not worried about the increased coverage stating that MD hospice programs always had this available to them. If a child meets hospice criteria for admission, hospices have been told to bill and they will be paid for curative treatment, or for therapies outside of the hospice cap. My guess is their is no data yet and no one has tracked this at all. Good questions.

Sue Huff
Director, Pediatrics at Home
Johns Hopkins Medicine
Baltimore, MD
Re:Concurrent Care for Children Requirement (by sfriebert on 04/24/2011)
Hi Bryan,
In addition to the Toolkit that Stacy mentioned (www.nhpco.org/pediatrics), next steps are to try to determine exactly what you're asking - how do we also expand services to patients who are not strictly hospice eligible, since this is the majority of patients cared for by most pediatric palliative care programs. Some states are working on benefits, and some groups have worked successfully with specific payers to design package services to allow for non-reimbursable parts of pediatric palliative care service provision to be paid for. The conversation is just beginning, however. If you're interested in joining the NHPCO and AAP workgroup that is tackling this issue, please contact me off line!
Thanks for asking this important question!
Sarah Friebert

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