Connecticut 2022 Regular Session

Connecticut House Bill HB05340 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
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4	4	LCO No. 2442 1 of 8
5	5
6	6	General Assembly Raised Bill No. 5340
7	7	February Session, 2022
8	8	LCO No. 2442
9	9
10	10
11	11	Referred to Committee on HUMAN SERVICES
12	12
13	13
14	14	Introduced by:
15	15	(HS)
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19	19
20	20	AN ACT CONCERNING EQUITABLE MEDICAID PAYMENTS AND
21	21	ELIGIBILITY DETERMINATIONS FOR APPLICANTS, RECIPIENTS
22	22	AND FAMILY CAREGIVERS.
23	23	Be it enacted by the Senate and House of Representatives in General
24	24	Assembly convened:
25	25
26	26	Section 1. (NEW) (Effective July 1, 2022) The Commissioner of Social 1
27	27	Services shall set payment rates for family caregivers authorized to 2
28	28	receive compensation in programs administered by the Department of 3
29	29	Social Services equal to the rates set for nonfamily professional 4
30	30	caregivers providing the same types of services to participants in such 5
31	31	programs, including, but not limited to, providing family caregivers 6
32	32	who provide personal care services the same rates received by personal 7
33	33	care attendants negotiated pursuant to section 17b-706b of the general 8
34	34	statutes. The commissioner shall utilize such rates to determine the 9
35	35	value of personal care services provided by a family caregiver to a 10
36	36	Medicaid applicant who transferred assets to the family caregiver as 11
37	37	part of a legally enforceable compensation agreement with such 12
38	38	caregiver. 13
39	39	Sec. 2. Subsection (h) of section 17b-342 of the 2022 supplement to the 14 Raised Bill No. 5340
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42	42
43	43	LCO No. 2442 2 of 8
44	44
45	45	general statutes is repealed and the following is substituted in lieu 15
46	46	thereof (Effective July 1, 2022): 16
47	47	(h) An individual who is otherwise eligible for services pursuant to 17
48	48	this section shall, as a condition of participation in the program, apply 18
49	49	for medical assistance benefits pursuant to section 17b-260 when 19
50	50	requested to do so by the department and shall accept such benefits if 20
51	51	determined eligible. The Commissioner of Social Services shall provide 21
52	52	medical assistance payments for Medicaid-eligible home care services 22
53	53	retroactive to not more than three months before the date an eligible 23
54	54	individual applied for Medicaid, to the extent permissible under 42 CFR 24
55	55	435.915, as amended from time to time. 25
56	56	Sec. 3. Section 17b-261 of the 2022 supplement to the general statutes 26
57	57	is repealed and the following is substituted in lieu thereof (Effective July 27
58	58	1, 2022): 28
59	59	(a) Medical assistance shall be provided for any otherwise eligible 29
60	60	person whose income, including any available support from legally 30
61	61	liable relatives and the income of the person's spouse or dependent 31
62	62	child, is not more than one hundred forty-three per cent, pending 32
63	63	approval of a federal waiver applied for pursuant to subsection (e) of 33
64	64	this section, of the benefit amount paid to a person with no income 34
65	65	under the temporary family assistance program in the appropriate 35
66	66	region of residence and if such person is an institutionalized individual 36
67	67	as defined in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), 37
68	68	and has not made an assignment or transfer or other disposition of 38
69	69	property for less than fair market value for the purpose of establishing 39
70	70	eligibility for benefits or assistance under this section. Any such 40
71	71	disposition shall be treated in accordance with Section 1917(c) of the 41
72	72	Social Security Act, 42 USC 1396p(c). Any disposition of property made 42
73	73	on behalf of an applicant or recipient or the spouse of an applicant or 43
74	74	recipient by a guardian, conservator, person authorized to make such 44
75	75	disposition pursuant to a power of attorney or other person so 45
76	76	authorized by law shall be attributed to such applicant, recipient or 46
77	77	spouse. A disposition of property ordered by a court shall be evaluated 47 Raised Bill No. 5340
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79	79
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81	81	LCO No. 2442 3 of 8
82	82
83	83	in accordance with the standards applied to any other such disposition 48
84	84	for the purpose of determining eligibility. The commissioner shall 49
85	85	establish the standards for eligibility for medical assistance at one 50
86	86	hundred forty-three per cent of the benefit amount paid to a household 51
87	87	of equal size with no income under the temporary family assistance 52
88	88	program in the appropriate region of residence. In determining 53
89	89	eligibility, the commissioner shall not consider as income Aid and 54
90	90	Attendance pension benefits granted to a veteran, as defined in section 55
91	91	27-103, or the surviving spouse of such veteran. Except as provided in 56
92	92	section 17b-277 and section 17b-292, the medical assistance program 57
93	93	shall provide coverage to persons under the age of nineteen with 58
94	94	household income up to one hundred ninety-six per cent of the federal 59
95	95	poverty level without an asset limit and to persons under the age of 60
96	96	nineteen, who qualify for coverage under Section 1931 of the Social 61
97	97	Security Act, with household income not exceeding one hundred 62
98	98	ninety-six per cent of the federal poverty level without an asset limit, 63
99	99	and their parents and needy caretaker relatives, who qualify for 64
100	100	coverage under Section 1931 of the Social Security Act, with household 65
101	101	income not exceeding one hundred fifty-five per cent of the federal 66
102	102	poverty level without an asset limit. Such levels shall be based on the 67
103	103	regional differences in such benefit amount, if applicable, unless such 68
104	104	levels based on regional differences are not in conformance with federal 69
105	105	law. Any income in excess of the applicable amounts shall be applied as 70
106	106	may be required by said federal law, and assistance shall be granted for 71
107	107	the balance of the cost of authorized medical assistance. The 72
108	108	Commissioner of Social Services shall provide applicants for assistance 73
109	109	under this section, at the time of application, with a written statement 74
110	110	advising them of (1) the effect of an assignment or transfer or other 75
111	111	disposition of property on eligibility for benefits or assistance, (2) the 76
112	112	effect that having income that exceeds the limits prescribed in this 77
113	113	subsection will have with respect to program eligibility, and (3) the 78
114	114	availability of, and eligibility for, services provided by the Connecticut 79
115	115	Home Visiting System, established pursuant to section 17b-751b. For 80
116	116	coverage dates on or after January 1, 2014, the department shall use the 81
117	117	modified adjusted gross income financial eligibility rules set forth in 82 Raised Bill No. 5340
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120	120
121	121	LCO No. 2442 4 of 8
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123	123	Section 1902(e)(14) of the Social Security Act and the implementing 83
124	124	regulations to determine eligibility for HUSKY A, HUSKY B and 84
125	125	HUSKY D applicants, as defined in section 17b-290. Persons who are 85
126	126	determined ineligible for assistance pursuant to this section shall be 86
127	127	provided a written statement notifying such persons of their ineligibility 87
128	128	and advising such persons of their potential eligibility for one of the 88
129	129	other insurance affordability programs as defined in 42 CFR 435.4. 89
130	130	(b) For the purposes of the Medicaid program, the Commissioner of 90
131	131	Social Services shall consider parental income and resources as available 91
132	132	to a child under eighteen years of age who is living with his or her 92
133	133	parents and is blind or disabled for purposes of the Medicaid program, 93
134	134	or to any other child under twenty-one years of age who is living with 94
135	135	his or her parents. 95
136	136	(c) For the purposes of determining eligibility for the Medicaid 96
137	137	program, an available asset is one that is actually available to the 97
138	138	applicant or one that the applicant has the legal right, authority or 98
139	139	power to obtain or to have applied for the applicant's general or medical 99
140	140	support. If the terms of a trust provide for the support of an applicant, 100
141	141	the refusal of a trustee to make a distribution from the trust does not 101
142	142	render the trust an unavailable asset. Notwithstanding the provisions of 102
143	143	this subsection, the availability of funds in a trust or similar instrument 103
144	144	funded in whole or in part by the applicant or the applicant's spouse 104
145	145	shall be determined pursuant to the Omnibus Budget Reconciliation Act 105
146	146	of 1993, 42 USC 1396p. The provisions of this subsection shall not apply 106
147	147	to a special needs trust, as defined in 42 USC 1396p(d)(4)(A), as 107
148	148	amended from time to time. For purposes of determining whether a 108
149	149	beneficiary under a special needs trust, who has not received a disability 109
150	150	determination from the Social Security Administration, is disabled, as 110
151	151	defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or 111
152	152	the commissioner's designee, shall independently make such 112
153	153	determination. The commissioner shall not require such beneficiary to 113
154	154	apply for Social Security disability benefits or obtain a disability 114
155	155	determination from the Social Security Administration for purposes of 115
156	156	determining whether the beneficiary is disabled. 116 Raised Bill No. 5340
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159	159
160	160	LCO No. 2442 5 of 8
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162	162	(d) The transfer of an asset in exchange for other valuable 117
163	163	consideration shall be allowable to the extent the value of the other 118
164	164	valuable consideration is equal to or greater than the value of the asset 119
165	165	transferred. 120
166	166	(e) The Commissioner of Social Services shall seek a waiver from 121
167	167	federal law to permit federal financial participation for Medicaid 122
168	168	expenditures for families with incomes of one hundred forty-three per 123
169	169	cent of the temporary family assistance program payment standard. 124
170	170	(f) To the extent [permitted by] permissible under federal law, 125
171	171	Medicaid eligibility shall be extended for one year to a family that 126
172	172	becomes ineligible for medical assistance under Section 1931 of the 127
173	173	Social Security Act due to income from employment by one of its 128
174	174	members who is a caretaker relative or due to receipt of child support 129
175	175	income. A family receiving extended benefits on July 1, 2005, shall 130
176	176	receive the balance of such extended benefits, provided no such family 131
177	177	shall receive more than twelve additional months of such benefits. 132
178	178	(g) An institutionalized spouse applying for Medicaid and having a 133
179	179	spouse living in the community shall be required, to the maximum 134
180	180	extent permitted by law, to divert income to such community spouse in 135
181	181	order to raise the community spouse's income to the level of the 136
182	182	minimum monthly needs allowance, as described in Section 1924 of the 137
183	183	Social Security Act. Such diversion of income shall occur before the 138
184	184	community spouse is allowed to retain assets in excess of the 139
185	185	community spouse protected amount described in Section 1924 of the 140
186	186	Social Security Act. The Commissioner of Social Services, pursuant to 141
187	187	section 17b-10, may implement the provisions of this subsection while 142
188	188	in the process of adopting regulations, provided the commissioner 143
189	189	[prints] posts notice of intent to adopt the regulations [in the 144
190	190	Connecticut Law Journal within] on the eRegulations System not later 145
191	191	than twenty days [of] after adopting such policy. Such policy shall be 146
192	192	valid until the time final regulations are effective. 147
193	193	(h) To the extent permissible under federal law, an institutionalized 148 Raised Bill No. 5340
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195	195
196	196
197	197	LCO No. 2442 6 of 8
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199	199	individual, as defined in Section 1917 of the Social Security Act, 42 USC 149
200	200	1396p(h)(3), shall not be determined ineligible for Medicaid solely on 150
201	201	the basis of the cash value of a life insurance policy worth less than ten 151
202	202	thousand dollars provided the individual is pursuing the surrender of 152
203	203	the policy. 153
204	204	(i) To the extent permissible under federal law, an individual who has 154
205	205	applied for Medicaid shall not be determined ineligible solely on the 155
206	206	basis of an asset discovered by such individual after the date of 156
207	207	application, provided (1) the individual reports the discovery of the 157
208	208	asset to the Commissioner of Social Services not later than ten days after 158
209	209	the discovery, (2) the individual takes steps within thirty days to 159
210	210	liquidate such individual's interest in the asset and spend down the 160
211	211	proceeds in accordance with Medicaid income and asset limits, and (3) 161
212	212	in the event the individual is unable to gain access to the asset, the 162
213	213	Department of Social Services provides assistance to the individual to 163
214	214	gain access to the asset. 164
215	215	(j) To the extent permissible under federal law, an individual who has 165
216	216	applied for Medicaid shall not be determined ineligible on the basis of a 166
217	217	single, unliquidated asset, provided such individual presents evidence 167
218	218	to the Commissioner of Social Services that such asset is inaccessible to 168
219	219	the individual because it is not possible to liquidate the asset in fewer 169
220	220	than thirty days. 170
221	221	[(i)] (k) Medical assistance shall be provided, in accordance with the 171
222	222	provisions of subsection (e) of section 17a-6, to any child under the 172
223	223	supervision of the Commissioner of Children and Families who is not 173
224	224	receiving Medicaid benefits, has not yet qualified for Medicaid benefits 174
225	225	or is otherwise ineligible for such benefits. Medical assistance shall also 175
226	226	be provided to any child in the behavioral services program operated 176
227	227	by the Department of Developmental Services who is not receiving 177
228	228	Medicaid benefits, has not yet qualified for Medicaid benefits or is 178
229	229	otherwise ineligible for benefits. To the extent practicable, the 179
230	230	Commissioner of Children and Families and the Commissioner of 180
231	231	Developmental Services shall apply for, or assist such child in qualifying 181 Raised Bill No. 5340
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233	233
234	234
235	235	LCO No. 2442 7 of 8
236	236
237	237	for, the Medicaid program. 182
238	238	[(j)] (l) The Commissioner of Social Services shall provide Early and 183
239	239	Periodic Screening, Diagnostic and Treatment program services, as 184
240	240	required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 185
241	241	42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal 186
242	242	regulations, to all persons who are under the age of twenty-one and 187
243	243	otherwise eligible for medical assistance under this section. 188
244	244	[(k)] (m) A veteran, as defined in section 27-103, and any member of 189
245	245	his or her family, who applies for or receives assistance under the 190
246	246	Medicaid program, shall apply for all benefits for which he or she may 191
247	247	be eligible through the United States Department of Veterans Affairs or 192
248	248	the United States Department of Defense. 193
249	249	[(l)] (n) On and after January 1, 2023, the Commissioner of Social 194
250	250	Services shall, within available appropriations, provide state-funded 195
251	251	medical assistance to any child eight years of age and younger, 196
252	252	regardless of immigration status, whose household income does not 197
253	253	exceed two hundred one per cent of the federal poverty level without 198
254	254	an asset limit and who does not otherwise qualify for Medicaid, the 199
255	255	Children's Health Insurance Program, or an offer of affordable, 200
256	256	employer-sponsored insurance as defined in the Affordable Care Act, as 201
257	257	an employee or a dependent of an employee. 202
258	258	This act shall take effect as follows and shall amend the following
259	259	sections:
260	260
261	261	Section 1 July 1, 2022 New section
262	262	Sec. 2 July 1, 2022 17b-342(h)
263	263	Sec. 3 July 1, 2022 17b-261
264	264
265	265	Statement of Purpose:
266	266	To (1) provide the same Medicaid payment rates to family caregivers
267	267	providing the same services as professional caregivers, (2) authorize
268	268	retroactive Medicaid coverage for home care if federally permissible,
269	269	and (3) not delay a Medicaid eligibility determination due to an asset Raised Bill No. 5340
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271	271
272	272
273	273	LCO No. 2442 8 of 8
274	274
275	275	discovered after the application or an asset that cannot be liquidated
276	276	within thirty days.
277	277	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
278	278	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
279	279	underlined.]
280	280