child with medically complex conditions

(A)Subject to subparagraph (B), the term “child with medically complex conditions” means an individual under 21 years of age who— (i)is eligible for medical assistance under the State plan (or under a waiver of such plan); and (ii)has at least— (I)one or more chronic conditions that cumulatively affect three or more organ systems and severely reduces cognitive or physical functioning (such as the ability to eat, drink, or breathe independently) and that also requires the use of medication, durable medical equipment, therapy, surgery, or other treatments; or (II)one life-limiting illness or rare pediatric disease (as defined insection 360ff(a)(3) of title 21). (B)Nothing in this paragraph shall prevent the Secretary from establishing higher levels as to the number or severity of chronic, life threatening illnesses, disabilities, rare diseases or mental health conditions for purposes of determining eligibility for receipt of health home services under this section.

Source

42 USC § 1396w-4a(i)(1)(A)


Scoping language

In this section
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