Relative to long-term care eligibility and making an appropriation therefor.
The bill would amend RSA 167:8, mandating the Department of Health and Human Services to grant provisional eligibility within 90 days of receiving a long-term care application, irrespective of whether the application is complete. The bill establishes that these individuals would be treated as fully eligible for nursing facility services for up to 18 months or until their final application approval or denial. The financial implications include an appropriation of $1,500,000 for the biennium ending June 30, 2027, to support the expenses incurred during this provisional eligibility phase.
Senate Bill 131 aims to enhance access to long-term care services by establishing a system of provisional eligibility for Medicaid nursing facility services. This provision allows individuals who apply for long-term care assistance to potentially receive care services even while their application is being evaluated, thus mitigating gaps in care. The proposed changes are designed to streamline the application process, allowing nursing facilities to provide services based on a provisional eligibility status, ensuring that applicants can still receive necessary care without delay while their Medicaid applications are processed.
Discussions surrounding SB 131 reflect a generally positive sentiment towards the bill, as it seeks to address the urgent need for timely access to long-term care services, especially for vulnerable populations. Proponents argue that the bill represents a significant step forward in ensuring that low-income individuals do not face interruptions in care while waiting for Medicaid approvals. However, some concerns have been raised regarding the potential financial burden placed on the state and the logistics of managing provisional payments to nursing facilities.
Notable points of contention involve how payments to nursing facilities will be managed under the provisional eligibility framework. Facilities that provide services under provisional eligibility are required to reimburse the state if the final determination of the application is not favorable. Critics may argue that this could place undue financial pressure on facilities, especially if they are not reimbursed in a timely manner. Additionally, the bill stipulates that counties will not be liable for provisional eligibility appropriations, which may raise concerns about the distribution of financial responsibilities among state and local levels.