SB-1039, As Passed Senate, November 8, 2018

 

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

SENATE BILL NO. 1039

 

 

 

 

 

 

 

 

 

 

 

     A bill to amend 1939 PA 280, entitled

 

"The social welfare act,"

 

(MCL 400.1 to 400.119b) by adding section 105g.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 105g. (1) Consistent with federal regulations, the

 

standard of promptness for establishing medical assistance

 

eligibility for individuals in nursing facilities shall be not more

 

than 90 days for a disabled individual and not more than 45 days

 

for a nondisabled individual. To ensure timely eligibility

 

determination, the department shall do all of the following:

 

     (a) Allocate to specific staff caseloads of nursing facility

 

residents applying for medical assistance in order to ensure

 

compliance with the standard of promptness. The staff allocated to

 

receive caseloads of nursing facility residents applying for

medical assistance may also receive caseloads for applications in

 

settings other than nursing facilities.

 

     (b) Collaborate with the nursing facility trade associations

 

to provide periodic training on medical assistance eligibility

 

processes and requirements.

 

     (c) Beginning October 1, 2019, report quarterly to the nursing

 

facility trade associations on compliance with the standard of

 

promptness timelines for medical-assistance-eligible nursing

 

facility residents. The report shall list compliance with the

 

standard of promptness by county and identify measures necessary to

 

meet that standard.

 

     (2) Beginning October 1, 2019, for a nursing facility

 

resident's annual eligibility redetermination, the department shall

 

do all of the following:

 

     (a) Implement an asset detection and verification process for

 

a medical-assistance-eligible nursing facility resident.

 

     (b) Provide to the recipient or his or her representative a

 

prepopulated form reflecting the information from the most recent

 

Medicaid application and allow the recipient or his or her

 

representative to attest to the information on the prepopulated

 

form to provide an accelerated redetermination process.

 

     (c) Collaborate with the nursing facility trade associations

 

to provide periodic training on medical assistance eligibility

 

redeterminations.

 

     (3) The department shall establish a divestment penalty

 

repayment fund of $3,000,000.00 to pay nursing facilities for care

 

provided to residents while subject to a divestment penalty period.

If the total divestment penalty debt claimed by all nursing

 

facilities in the state exceeds $3,000,000.00, the funds shall be

 

dispersed to each nursing facility claiming divestment penalty debt

 

at a percentage covered by the fund. If the total divestment

 

penalty debt claimed by all nursing facilities in the state is less

 

than $3,000,000.00, general fund money remaining shall not lapse to

 

the general fund, but shall remain available in the next fiscal

 

year.

 

     (4) The department shall make available an outstation worker

 

to utilize to facilitate Medicaid eligibility determination to a

 

nursing facility that requests an outstation worker.

 

     (5) Beginning October 1, 2018, if a recipient residing in a

 

nursing facility has a court-ordered payment or garnishment, the

 

department must automatically apply the court-ordered payment or

 

garnishment before determining the patient-pay amount.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.