HB-4270,As Passed Senate, June 12, 2003                                     

SENATE SUBSTITUTE FOR

HOUSE BILL NO. 4270

                                                                             A bill to amend 1939 PA 280, entitled                                             

"The social welfare act,"                                                   

by amending section 106 (MCL 400.106), as amended by 1990 PA                

145.                                                                        

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1       Sec. 106.  (1) A medically indigent individual is defined                   

2   as:                                                                         

3       (a) An individual receiving  aid to dependent children

4   family independence program benefits or an individual receiving             

5   supplemental security income under title XVI  of the social                 

6   security act, 42 U.S.C. 1381 to 1385,  or state supplementation             

7   thereunder under title XVI subject to limitations imposed by              

8   the director  pursuant according to title XIX.                             

9       (b)  An Except as provided in section 106a, an individual                  

10  meeting who meets all of the following conditions:                        

1                                                                                (i) The individual has  made application applied in the                            

2   manner  prescribed by  the  state department family independence           

3   agency prescribes.                                                          

4       (ii) The individual's need for the type of medical assistance                

5   available under this act for which  application has been made

6   the individual applied has been professionally established and              

7   payment for it is not available through the legal obligation of a           

8   public or private contractor  , public or private,  to pay or               

9   provide for the care without regard to the income or resources of           

10  the patient.  The state department  shall be is subrogated to              

11  any right of recovery  which that a patient may have for the               

12  cost of hospitalization, pharmaceutical services, physician                 

13  services, nursing services, and other medical services not to               

14  exceed the amount of funds expended by the department for the               

15  care and treatment of the patient.  The patient or other person             

16  acting in the patient's behalf shall execute and deliver an                 

17  assignment of claim or other authorizations as necessary to                 

18  secure the right of recovery to the department.  A payment may be           

19  withheld under this act for medical assistance for an injury or             

20  disability for which the patient is entitled to medical care or             

21  reimbursement for the cost of medical care under sections 3101 to           

22  3179 of the insurance code of 1956,  Act No. 218 of the Public              

23  Acts of 1956, as amended, being sections 500.3101 to 500.3179 of            

24  the Michigan Compiled Laws 1956 PA 218, MCL 500.3101 to                    

25  500.3179, or under  any other another policy of insurance                  

26  providing medical or hospital benefits, or both, for the patient            

27  unless the patient's entitlement to that medical care or                    

1   reimbursement is at issue.  If a payment is made, the state                 

2   department, to enforce its subrogation right, may do either of              

3   the following:  (a) intervene or join in an action or proceeding            

4   brought by the injured, diseased, or disabled person, the                   

5   person's guardian, personal representative, estate, dependents,             

6   or survivors, against the third person who may be liable for the            

7   injury, disease, or disability, or against contractors, public or           

8   private, who may be liable to pay or provide medical care and               

9   services rendered to an injured, diseased, or disabled patient;             

10  (b) institute and prosecute a legal proceeding against a third              

11  person who may be liable for the injury, disease, or disability,            

12  or against contractors, public or private, who may be liable to             

13  pay or provide medical care and services rendered to an injured,            

14  diseased, or disabled patient, in state or federal court, either            

15  alone or in conjunction with the injured, diseased, or disabled             

16  person, the person's guardian, personal representative, estate,             

17  dependents, or survivors.  The state department may institute the           

18  proceedings in its own name or in the name of the injured,                  

19  diseased, or disabled person, the person's guardian, personal               

20  representative, estate, dependents, or survivors.  As provided in           

21  section 6023 of the revised judicature act of 1961,  Act No. 236            

22  of the Public Acts of 1961, as amended, being section 600.6023 of           

23  the Michigan Compiled Laws 1961 PA 236, MCL 600.6023, the state            

24  department, in enforcing its subrogation right, shall not satisfy           

25  a judgment against the third person's property  which that is              

26  exempt from levy and sale.  The injured, diseased, or disabled              

27  person may proceed in his or her own name, collecting the costs             

1   without the necessity of joining the state department or the                

2   state as a named party.  The injured, diseased, or disabled                 

3   person shall notify the state department of the action or                   

4   proceeding entered into upon commencement of the action or                  

5   proceeding.  An action taken by the state or the state department           

6   in connection with the right of recovery afforded by this section           

7   does not  operate to  deny the injured, diseased, or disabled               

8   person any part of the recovery beyond the costs expended on the            

9   person's behalf by the state department.  The costs of legal                

10  action initiated by the state shall be paid by the state.  A                

11  payment shall not be made under this act for medical assistance             

12  for an injury, disease, or disability for which the patient is              

13  entitled to medical care or the cost of medical care under the              

14  worker's disability compensation act of 1969,  Act No. 317 of the           

15  Public Acts of 1969, as amended, being sections 418.101 to                  

16  418.941 of the Michigan Compiled Laws 1969 PA 317, MCL 418.101             

17  to 418.941; except that payment may be made if an appropriate               

18  application for medical care or the cost of the medical care has            

19  been made under  Act No. 317 of the Public Acts of 1969, as                 

20  amended the worker's disability compensation act of 1969, 1969             

21  PA 317, MCL 418.101 to 418.941, entitlement has not been finally            

22  determined, and an arrangement satisfactory to the state                    

23  department has been made for reimbursement if the claim under               

24  Act No. 317 of the Public Acts of 1969, as amended the worker's           

25  disability compensation act of 1969, 1969 PA 317, MCL 418.101 to            

26  418.941, is finally sustained.                                              

27      (iii) The individual has an annual income  which that is                    

1   below, or because of medical expenses falls below, the protected            

2   basic maintenance level.  The protected basic maintenance level             

3   for 1-person and 2-person families shall be at least 100% of the            

4   higher of the payment standards generally used to determine                 

5   eligibility in the  aid to dependent children family                       

6   independence program and the supplemental security income program           

7   under title XVI,  of the social security act, 42 U.S.C. 1381 to             

8   1385,  including state supplementation.  For families of 3 or               

9   more persons, the protected basic maintenance level shall be at             

10  least 100% of the payment standard generally used to determine              

11  eligibility in the  aid to dependent children family                       

12  independence program.  These levels shall recognize regional                

13  variations and shall not exceed 133-1/3% of the payment standard            

14  generally used to determine eligibility in the  aid to dependent            

15  children family independence program.                                      

16      (iv) The individual, if  an aid to dependent children a                     

17  family independence program related individual and living alone,            

18  has liquid or marketable assets of not more than  $1,500.00

19  $2,000.00 in value, or, if a 2-person family, the family has                

20  liquid or marketable assets of not more than  $2,000.00

21  $3,000.00 in value.  The  state department family independence             

22  agency shall establish comparable liquid or marketable asset                

23  amounts for larger family groups.  Excluded in making the                   

24  determination of the value of liquid or marketable assets are the           

25  values of:  the homestead; clothing; household effects; $1,000.00           

26  of cash surrender value of life insurance, except that if the               

27  health of the insured  is such as to make makes continuance of             

1   the insurance desirable, the entire cash surrender value of life            

2   insurance is  to be  excluded from consideration, up to the                 

3   maximums maximum provided or allowed by federal regulations and           

4   in accordance with the rules of the  state department family               

5   independence agency; the fair market value of tangible personal             

6   property used in earning income; an amount paid as judgment or              

7   settlement for damages suffered as a result of exposure to agent            

8   orange, as defined in section 5701 of the public health code,               

9   Act No. 368 of the Public Acts of 1978, being section 333.5701             

10  of the Michigan Compiled Laws 1978 PA 368, MCL 333.5701; and a             

11  space or plot purchased for the purposes of burial for the                  

12  person.  For individuals related to the title XVI program,  of              

13  the social security act, 42 U.S.C. 1381 to 1385,  the appropriate           

14  resource levels and property exemptions specified in title XVI              

15  shall be used.                                                              

16      (v) The individual is not an inmate of a public institution                 

17  except as a patient in a medical institution.                               

18      (vi) The individual meets the eligibility standards for                      

19  supplemental security income under title XVI  of the social                 

20  security act, 42 U.S.C. 1381 to 1385,  or for state                         

21  supplementation under the act, subject to limitations imposed by            

22  the director  pursuant according to title XIX; or meets the                

23  eligibility standards for  aid to dependent children family                

24  independence program benefits, except for income or income and              

25  resources; or is a child from 18 to 21 years of age and his or              

26  her adult caretaker would be eligible for  aid to dependent                 

27  children family independence program benefits except for age,              

1   income, or income and resources; or is a child under 21 years of            

2   age and is from a family whose income is below the basic                    

3   maintenance level.                                                          

4       (2) As used in this act:  , "medical"

5   (a) "Medical institution" means a state licensed or approved                

6   hospital, nursing home, medical care facility, psychiatric                  

7   hospital, or other facility or identifiable unit  thereof of a             

8   listed institution certified as meeting established standards for           

9   a nursing home or hospital in accordance with the laws of this              

10  state.                                                                      

11  (b) "Title XVI" means title XVI of the social security act,                 

12  chapter 531, 49 Stat. 620, 42 U.S.C. 1381 to 1382j and 1383 to              

13  1383f.

14      Enacting section 1.  This amendatory act does not take                      

15  effect unless Senate Bill No. 22 of the 92nd Legislature is                 

16  enacted into law.