September 14, 2006, Introduced by Reps. Vander Veen, Zelenko, Newell, Marleau, Brandenburg, Gaffney, Hummel, Caswell, Stahl, Amos, Green, Hansen, Booher, Sheen, Kahn and Huizenga and referred to the Committee on Senior Health, Security, and Retirement.
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
by amending sections 112b, 112c, and 112e (MCL 400.112b, 400.112c,
and 400.112e), as added by 1995 PA 85; and to repeal acts and parts
of acts.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 112b. As used in this section and sections 112c to 112e:
(a)
"Home health care" means care described in section 109c.
(a) "Asset disregard" means, with regard to the state's
medical assistance program, disregarding any assets or resources in
an amount equal to the insurance benefit payments that are made to
or on behalf of an individual who is a beneficiary under a
qualified long-term care insurance partnership policy.
(b) "Long-term care insurance policy" means a policy described
in
chapter 39 of the insurance code of 1956, Act No. 218 of the
Public
Acts of 1956, being sections 500.3901 to 500.3955 of the
Michigan
Compiled Laws 1956 PA 218,
MCL 500.3901 to 500.3955.
(c) "Long-term care partnership program" means a qualified
state long-term care insurance partnership as defined in section
1917(b) of the social security act, 42 USC 1396p.
(d) "Long-term care partnership program policy" means a
qualified long-term care insurance policy that the commissioner of
the office of financial and insurance services certifies as meeting
the requirements of section 1917(b) of the social security act, 42
USC 1396p, section 6021 of the federal deficit reduction act of
2005, Public Law 109-171, and any applicable federal regulations or
guidelines.
(e) (c)
"Medicaid" means the program of medical
assistance
established by the department of community health under section
105.
(d)
"Nursing home care" means nursing home services as
described
in section 109(1)(c).
(e)
"Partnership policy" means a long-term care insurance
policy
that meets the requirements set forth in section 112d.
(f)
"Partnership program" means the Michigan partnership for
long-term
care program established under section 112c.
Sec.
112c. (1) Subject to subsection (4) (5), the department
of community health in conjunction with the office of financial and
insurance services and the department of human services shall
establish the
Michigan partnership for long-term care program a
long-term care partnership program in Michigan to provide for the
financing of long-term care through a combination of private
insurance and medicaid. The long-term care partnership program
shall do all of the following:
(a) Provide incentives for individuals to insure against the
costs of providing for their long-term care needs.
(b) Provide a mechanism for individuals to qualify for
coverage of the cost of their long-term care needs under medicaid
without first being required to substantially exhaust their
resources.
(c) Alleviate the financial burden on the state’s medical
assistance program by encouraging the pursuit of private
initiatives.
(2)
An individual is eligible to participate in the
partnership
program if he or she meets all of the following
requirements:
(a)
Is a Michigan resident.
(b)
Purchases a partnership policy that is delivered, issued
for
delivery, or renewed on or after the effective date of this
section,
and maintains the partnership policy in effect throughout
the
period of participation in the partnership program.
(c)
Exhausts the minimum benefits under the partnership policy
as
described in section 112d(1)(a). Benefits received under a long-
term
care insurance policy before the effective date of this
section
do not count toward the exhaustion of benefits required in
this
subdivision.
(3)
Upon application of an individual who meets the
requirements
described in subsection (2), the department shall
determine
the individual's eligibility for medicaid in accordance
with
both of the following:
(a)
After disregarding financial assets exempted under
medicaid
eligibility requirements, the department shall disregard
an
additional amount of financial assets equal to the dollar amount
of
coverage under the partnership policy.
(b)
The department shall consider the individual's income in
accordance
with medicaid eligibility requirements.
(4)
The department shall seek appropriate amendments to the
medicaid
state plan and shall apply for any necessary waiver of
medicaid
requirements by the federal health care financing
administration
to implement the partnership program.
(5)
The department shall not implement the partnership program
unless
both of the following apply:
(a)
A federal waiver of medicaid requirements is obtained, if
necessary.
(b)
Federal law exempts individuals who receive medicaid under
this
section from estate recovery requirements under section 1917
of
title XIX of the social security act, 42 U.S.C. 1396p.
(2) An individual who is a beneficiary of a Michigan long-term
care partnership program policy is eligible for assistance under
the state’s medical assistance program using the asset disregard as
provided under subsection (5).
(3) The department of community health may enter into
reciprocal agreements with other states to extend the asset
disregard to Michigan residents who purchased long-term care
partnership polices in other states that are compliant with title
VI, section 6021 of the federal deficit reduction act of 2005,
Public Law 109-171, and any applicable federal regulations or
guidelines.
(4) Upon the exhaustion of benefits or upon the diminishment
of assets below the anticipated remaining benefits under a long-
term care partnership program policy, certain assets of an
individual, as provided under subsection (5), shall not be
considered when determining any of the following:
(a) Medicaid eligibility.
(b) The amount of any medicaid payment.
(c) Any subsequent recovery by the state of a payment for
medical services.
(5) Not later than 180 days after the effective date of the
amendatory act that added this subsection, the department of
community health shall apply to the United States department of
health and human services for an amendment to the state’s medicaid
state plan to establish that the assets an individual owns and may
retain under medicaid and still qualify for benefits under medicaid
at the time the individual applies for benefits is increased
dollar-for-dollar for each dollar paid out under the individual’s
long-term care insurance policy if the individual is a beneficiary
of a qualified long-term care partnership program policy.
(6) If the long-term care partnership program is discontinued,
an individual who purchased a Michigan long-term care partnership
program policy before the date the program was discontinued shall
be eligible to receive asset disregard if allowed as provided by
title VI, section 6021 of the federal deficit reduction act of
2005, Public Law 109-171.
(7) The department of community health may contract with a
nonprofit organization to provide counseling services under the
Michigan long-term care partnership program.
Sec. 112e. The department of community health may promulgate
rules
pursuant to the administrative procedures act of 1969, Act
No.
306 of the Public Acts of 1969, being sections 24.201 to 24.328
of
the Michigan Compiled Laws 1969
PA 306, MCL 24.201 to 24.328,
as necessary to implement the partnership program in accordance
with the requirements of section 1917(b) of the social security
act, 42 USC 1396p, section 6021 of the federal deficit reduction
act of 2005, Public Law 109-171, and applicable federal regulations
or guidelines.
Enacting section 1. Section 112d of the social welfare act,
1939 PA 280, MCL 400.112d, is repealed.