Bill Text: CT SB01084 | 2013 | General Assembly | Comm Sub
Bill Title: An Act Concerning Delays In Medicaid Application Processing.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2013-04-05 - Favorable Change of Reference, House to Committee on Appropriations [SB01084 Detail]
Download: Connecticut-2013-SB01084-Comm_Sub.html
General Assembly |
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January Session, 2013 |
*_____SB01084HS_APP040313____* |
AN ACT CONCERNING DELAYS IN MEDICAID APPLICATION PROCESSING.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 17b-261 of the general statutes is amended by adding subsection (k) as follows (Effective July 1, 2013):
(NEW) (k) Not later than April 1, 2014, the Commissioner of Social Services shall utilize technology to ensure that applications for medical assistance under the Medicaid program established pursuant to Title XIX of the Social Security Act are processed with reasonable promptness. Except for unusual circumstances as described in 42 CFR 435.911(c), the commissioner shall ensure that a determination is made not later than forty-five days after the date of receipt by the Department of Social Services of a nondisability-based eligibility application for Medicaid and not later than ninety days after the date of receipt by the department of a disability-based Medicaid application. If the commissioner determines that an application for Medicaid lacks sufficient documentation, the commissioner shall send written notice to the applicant not later than seven days after such determination detailing (1) a list of documents the applicant must provide, (2) a date by which the applicant must provide the documents, and (3) an estimated time by which the commissioner shall make an eligibility determination after receipt of such documents.
Sec. 2. (NEW) (Effective July 1, 2013) (a) The Commissioner of Social Services shall establish a pilot presumptive Medicaid eligibility program for home and community-based care in New Haven County for up to three hundred elderly applicants who require a skilled level of nursing care. Such program shall commence not later than April 1, 2014, and shall include, but not be limited to: (1) The development by the Department of Social Services of a preliminary screening tool to determine whether an applicant is functionally able to live at home or in a community-based setting and is more likely than not to be financially eligible for Medicaid; (2) a written agreement to be signed by such applicant attesting to the accuracy of financial and other information such applicant provides and acknowledging that (A) state-funded services in advance of a final Medicaid eligibility determination shall be provided for not longer than ninety days, and (B) such applicant shall complete a Medicaid application on the date such applicant is screened for functional ability or not later than ten days after such screening; (3) a presumptive financial Medicaid eligibility determination for such applicant by the department not later than four days after such applicant has completed a Medicaid application and is determined to be functionally able to live at home or in a community-based setting; and (4) the initiation of state-funded home and community-based care services for such applicant not later than five days after the applicant has been determined to be presumptively eligible for Medicaid. The Department of Social Services shall make a final determination as to Medicaid eligibility for presumptive eligibility applicants not later than forty-five days after receipt of a completed Medicaid application from such applicant.
(b) Pursuant to state and federal law, the Commissioner of Social Services shall retroactively apply a final determination of Medicaid eligibility for presumptive eligibility applicants for a period not to exceed ninety days. The commissioner shall request available federal matching Medicaid funds for state costs during the presumptive Medicaid eligibility period for applicants determined to be eligible for Medicaid coverage. The commissioner, in consultation with the Commissioner on Aging, shall identify funding pursuant to the federal Older Americans Act of 1965, as amended from time to time, that may be allocated to subsidize costs during the presumptive eligibility period for those applicants who are not determined eligible for Medicaid. State costs during the presumptive eligibility period shall be offset by federal Medicaid reimbursements and savings realized for institutional care that would have been necessary but for the presumptive eligibility system.
(c) Not later than April 1, 2015, the Commissioner of Social Services shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies detailing: (1) The percentage of applicants determined to be presumptively eligible for Medicaid who were not finally determined to be eligible for Medicaid; (2) costs per applicant to provide home and community-based services for the presumptive eligibility period; (3) estimated savings realized by the state on the cost of institutional care for those determined to be eligible for Medicaid; and (4) recommendations on whether the pilot program should be expanded.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
July 1, 2013 |
17b-261 |
Sec. 2 |
July 1, 2013 |
New section |
HS |
Joint Favorable Subst. C/R |
APP |