General Assembly Raised Bill No. 116
February Session, 2016 LCO No. 1405
*01405_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
General Assembly
Raised Bill No. 116
February Session, 2016
LCO No. 1405
*01405_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING CAREGIVER AGREEMENT REQUIREMENTS FOR MEDICAID APPLICANTS OR RECIPIENTS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. (NEW) (Effective from passage) (a) For purposes of this section, "caregiver agreement" means a written agreement between a Medicaid applicant or recipient and a family member of such applicant or recipient in which the Medicaid applicant or recipient agrees to pay the family member for providing services to the applicant or recipient. The Department of Social Services shall not impose a penalty for improper transfer of assets on a Medicaid applicant or recipient for payments made to a family member pursuant to a caregiver agreement, provided the agreement satisfies the provisions of this section and the applicant or recipient establishes that the services avoid or delay the applicant's or recipient's (1) placement in a nursing home facility, or (2) need for home and community-based services provided under a Medicaid waiver.
(b) For purposes of determining eligibility for Medicaid payment for long-term services, caregiver agreements after the effective date of this section shall:
(1) Be executed prior to the delivery of services;
(2) Be signed and dated by the applicant or recipient and the family member who provides the services;
(3) Be notarized;
(4) Include the frequency, location and duration of services that will be provided;
(5) Provide for payment to the provider of services on a daily, weekly, biweekly or monthly basis for services received and prohibit prepayment for the provision of such services;
(6) Provide for payment for services at rates (A) not more than the average private pay rates for home and community-based services determined and published annually by Connecticut's Partnership for Long-Term Care through the Office of Policy and Management and, (B) for those services for which no rate is so published and posted, not more than twice the state minimum wage at the time the services were provided;
(7) Allow for modification of the agreement only by mutual written agreement of the parties;
(8) Allow for termination of the agreement by either party at any time and only in writing;
(9) Require the provider of services to maintain contemporaneous records of services provided and to submit copies of such records and itemized bills to the recipient;
(10) Include only those services that are not duplicative of services provided by others; and
(11) Not provide payment for (A) social activities or companionship, (B) services provided while the applicant or recipient is in a nursing home or other health care facility, or (C) travel by the provider of services to or from the residence of the applicant or recipient.
(c) In determining eligibility for Medicaid, the department may require an applicant or recipient to provide, in addition to other documentation: (1) Copies of the contemporaneous records of services provided by and itemized bills received from the provider of services pursuant to a caregiver agreement; and (2) documentation establishing that the applicant or recipient of services has complied with state and federal tax requirements governing payments made to a provider of services pursuant to a caregiver agreement.
This act shall take effect as follows and shall amend the following sections:
Section 1 from passage New section
This act shall take effect as follows and shall amend the following sections:
Section 1
from passage
New section
Statement of Purpose:
To prevent Medicaid applicants or recipients from improperly transferring assets to gain eligibility for Medicaid funded long-term care via agreements to pay family members for providing care to such applicants or recipients.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]