Bill Text: HI SB2713 | 2012 | Regular Session | Amended
Bill Title: Medicaid; Liens; Community Care Foster Family Homes
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed - Dead) 2012-04-24 - (S) The conference committee deferred the measure. [SB2713 Detail]
Download: Hawaii-2012-SB2713-Amended.html
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THE SENATE |
S.B. NO. |
2713 |
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TWENTY-SIXTH LEGISLATURE, 2012 |
S.D. 1 |
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STATE OF HAWAII |
H.D. 2 |
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A BILL FOR AN ACT
RELATING TO MEDICAID.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
SECTION 1. The legislature finds that the lien amounts stated in the department of human services' notice of lien have been challenged on numerous occasions in cases where the department is seeking restitution.
The purpose of this part is to clarify that the lien amount stated in notices of lien sent by the department of human services for reimbursement of medicaid benefits shall be presumed to be valid under certain conditions.
SECTION 2. Section 346-29.5, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) The department may also place a lien against the real property of any recipient receiving medical assistance who is an inpatient in a nursing facility, intermediate care facility for individuals with intellectual disabilities, or other medical institution, after a state determination, pursuant to notice and hearing requirements of chapter 91, that the recipient cannot reasonably be expected to be discharged from the medical institution and returned home.
When restitution is sought in connection with the sentencing of a third person who has caused injury to a recipient of medical assistance, the department shall provide to the person against whom restitution is sought a written notice of lien and an itemized list of payments that identifies the provider of services, dates of service provision, amounts billed, amounts paid, and dates of payments. Absent a good faith basis contesting the amount or validity of a specific line item charge or charges in the lien, the entire amount shall be presumed to be valid in determining the amount of restitution.
There is a rebuttable presumption that the recipient cannot reasonably be expected to be discharged from the facility and return home if the recipient or a representative of the recipient declares that there is no intent to return home or if the recipient has been institutionalized for six months or longer without a discharge plan.
(1) The department may not place a lien on the recipient's home if the recipient's:
(A) Spouse;
(B) Minor, blind, or disabled child; or
(C) Sibling who has an equity interest in the home and who was residing in the home for a period of at least one year immediately before the date of the recipient's admission to the medical institution;
is lawfully residing in the home.
(2) The department shall not recover funds from the lien on the recipient's home when:
(A) A sibling who was residing in the home for a period of at least one year immediately before the date of the recipient's admission to the medical institution; or
(B) A son or daughter who was residing in the recipient's home for a period of at least two years immediately before the date of the recipient's admission to the medical institution, and who establishes to the satisfaction of the State that he or she provided care to the recipient which permitted such recipient to reside at home rather than in an institution;
lawfully resides in the home and has lawfully resided in the home on a continuous basis since the date of the recipient's admission to the medical institution.
(3) The department also shall
not recover funds from the lien if the recipient has a surviving spouse[;]
or surviving minor, blind, or disabled child.
(4) Any lien imposed with respect to this subsection shall be dissolved upon the individual's discharge from the medical institution and return home."
SECTION 3. Section 346-37, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:
"(g) The
lien of the department for reimbursement of costs of medical assistance or
burial payments under subsection (f), shall attach by a written notice of lien
served upon the claimant's attorney or upon the third person, the third
person's agent, attorney, or insurance company. The method of service shall be
by certified or registered mail, return receipt requested, or by delivery of
the notice of lien personally to the individuals referred to. Service by
certified or registered mail is complete upon receipt. The notice of lien
shall state the name of the injured, diseased, or deceased person, the amount
of the lien, and the date of the accident or incident which caused the
injuries, disease, or death which necessitated the department's medical
assistance or burial payments. If the notice of lien is served upon the
claimant's attorney, the notice of lien shall state that the claimant's
attorney shall pay the full amount of the lien from the proceeds of any
judgment, settlement, or compromise based on the incident or accident. If the
notice of lien is served upon the third person[,] or the third person's
agent, attorney, or insurance company, the notice of lien shall state that the
third person shall pay the full amount of the lien prior to disbursing any of
the proceeds to the claimant or to the claimant's attorney. A notice of lien
may be amended from time to time until extinguished, each amendment taking
effect upon proper service.
When restitution is sought in connection with the sentencing of a third person who has caused injury to a recipient of medical assistance, the department shall provide to the person against whom restitution is sought a written notice of lien and an itemized list of payments that identifies the provider of services, dates of service provision, amounts billed, amounts paid, and dates of payments. Absent a good faith basis contesting the amount or validity of a specific line item charge or charges in the lien, the entire amount shall be presumed to be valid in determining the amount of restitution."
PART II
SECTION 4. Section 346-332, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) Community care foster family homes
shall be required to reserve at least one bed for medicaid patients[.];
provided that if:
(1) A medicaid patient, who is the only medicaid patient residing in the community care foster family home, leaves the community care foster family home; and
(2) There is only one remaining private-pay client in the community care foster family home and a physician who is licensed to practice under chapter 453 has certified to the department in a timely manner that the removal of that private-pay client from the community care foster family home may cause that client to sustain transfer trauma,
then the department may not, for a period of at least six months following the medicaid patient's departure, and on account of the medicaid patient's departure, suspend or revoke the certificate of approval issued to the community care foster family home under section 346-334."
SECTION 5. Section 346-334, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) The department shall adopt rules pursuant to chapter 91 relating to:
(1) Standards of conditions and competence for the operation of community care foster family homes;
(2) Procedures for obtaining and renewing a certificate of approval from the department;
(3) Minimum grievance procedures for clients of community care foster family home services; and
(4) Requirements for primary and substitute caregivers caring for three clients in community care foster family homes including:
(A) Mandating that primary [and substitute]
caregivers be twenty-one years of age or older[;], and substitute
caregivers be eighteen years of age or older;
(B) Mandating that primary and substitute
caregivers complete a minimum of twelve hours of continuing education every
twelve months or [at least] a minimum of twenty-four hours of
continuing education every twenty-four months;
(C) Allowing the primary caregiver to be absent from the community care foster family home for no more than twenty-eight hours in a calendar week, not to exceed five hours per day; provided that the substitute caregiver is present in the community care foster family home during the primary caregiver's absence;
(D) Where the primary caregiver is absent from the community care foster family home in excess of the hours as prescribed in subparagraph (C), mandating that the substitute caregiver be a certified nurse aide; and
(E) Mandating that the substitute caregiver have, at a minimum, one year prior work experience as a caregiver in a community residential setting or in a medical facility."
PART III
SECTION 6. It is the intent of this Act not to jeopardize the receipt of any federal aid. If any provision of this Act, or the application thereof to any person or circumstance is found to be in conflict with federal requirements that are a prescribed condition for the allocation of federal funds to the State, the provision shall be deemed void; provided that the voided provision shall not affect other provisions or applications of the Act that can be given effect without the voided provision or application, and to this end the provisions of this Act are severable.
SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 8. This Act shall take effect on July 1, 2050; provided that the amendments made to section 346-334(b), Hawaii Revised Statutes, by section 5 of this Act shall not be repealed when section 346-334(b), Hawaii Revised Statutes, is reenacted on June 30, 2013, pursuant to Act 221, Session Laws of Hawaii 2011.
Report Title:
Medicaid; Liens; Community Care Foster Family Homes
Description:
Sets lien requirements for the liens for restitution from a third party. For community care foster family homes, temporarily delays loss of license upon departure of last Medicaid client and lowers substitute caregiver minimum age. Effective July 1, 2050. (SB2713 HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
