Due Process Continuity of Care Act
The Due Process Continuity of Care Act would, for the first time, extend Medicaid coverage to people who are in jail or prison while their charges are pending disposition. It removes the current exclusion that blocks Medicaid benefits for inmates and requires states to maintain coverage (with the possibility to suspend it during custody) rather than terminate it outright. The bill also creates a new planning grants program (authorized at $50 million) to help states develop and implement systems for providing Medicaid-covered health services to this population, including recruiting providers, building infrastructure, and ensuring care quality and proper electronic health record billing. The overall aim is to ensure continuity of healthcare for detained individuals and to plan for scalable state-level implementation. If enacted, the effective date provisions mean the coverage change would begin in the first calendar quarter after enactment (with services for periods starting on or after that date). States would receive planning grants to design and carry out the program, and would be encouraged to engage a broad set of stakeholders (health providers, jails, law enforcement, beneficiaries, managed care plans) in the planning process.
Key Points
- 1Removal of inmate exclusion: The Medicaid eligibility requirement would be amended so that individuals in custody pending disposition of charges can receive Medicaid-covered items and services, rather than being excluded.
- 2Effective date and scope: The new coverage rule takes effect on the first calendar quarter after enactment minus a 60-day window, and applies to items and services furnished on or after that date.
- 3Conforming amendment to eligibility rules: States would not have to terminate Medicaid eligibility for inmates; they may suspend coverage during the custody period (with certain conditions), aligning treatment with the new policy.
- 4Planning grants program: The Secretary would award planning grants to states to support implementing Medicaid coverage for this population, including developing processes, reviewing state policies, and building provider capacity.
- 5Grant requirements and activities: States must describe how they will expand provider access (physical health, behavioral health, substance use treatment), set milestones and measurable targets, and consult a wide range of stakeholders. Activities include initial health needs assessments, provider capacity analyses, and developing infrastructure for billing and electronic health records to reimburse services.