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A09278 Summary:

BILL NOA09278
 
SAME ASSAME AS S06414
 
SPONSORPaulin
 
COSPNSR
 
MLTSPNSR
 
Rpld 366 sub 5 (e) sub 1 cl (xi), amd 366, Soc Serv L
 
Eliminates the "look-back period" for home care for non-institutionalized Medicaid applicants; repeals a certain provision of law relating thereto.
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A09278 Actions:

BILL NOA09278
 
02/23/2024referred to health
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A09278 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A9278
 
SPONSOR: Paulin
  TITLE OF BILL: An act to amend the social services law, in relation to eliminating a "look-back period" for home care for non-institutionalized Medicaid applicants; and repealing certain provisions of such law relating there- to   PURPOSE: To eliminate a look-back period for home care for home health care Medi- caid applicants.   SUMMARY OF PROVISIONS: Section 1: repeals the definition of a non-institutionalized individual Section 2: Removes the consideration of asset transfers for non-institu- tionalized individuals for eligibility for community based long term care service. Section 3: Removes the 30 month period for non-institutionalized indi- viduals in the definition of a look-back period. Section 4: Sets the effective date   JUSTIFICATION: The SFY 2020-21 enacted budget added a 30 month "look back" period for home health care Medicaid applicants. A look back period is a duration of time during which the government reviews an individual's financial transactions to determine whether they have transferred assets for less than fair market value in order to qualify for Medicaid coverage for long-term care. Look back periods had never applied to home health care previous to the SFY 2020-21 enacted budget provision, and the change makes it more difficult for seniors to be eligible for Medicaid and homecare. Prior to the look back period requirement, health care Medicaid approval was much faster, which is vital for senior citizens and those with disa- bilities since home care agencies cannot provide free care while appli- cants wait extended periods of time for Medicaid approval. Around the clock home care can cost as much as a nursing home, which will push more people into nursing homes where at least care will start immediately. This bill will repeal the look back period for home health care Medicaid applicants so that older adults and people with disabilities will not find themselves unnecessarily locked out of services that would protect them in their homes and keep them safe from unnecessary institutionali- zation.   LEGISLATIVE HISTORY: New Bill.   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect immediately.
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A09278 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          9278
 
                   IN ASSEMBLY
 
                                    February 23, 2024
                                       ___________
 
        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health
 
        AN  ACT  to  amend the social services law, in relation to eliminating a
          "look-back period" for home care  for  non-institutionalized  Medicaid
          applicants;  and  repealing  certain  provisions  of such law relating
          thereto
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Clause (xi) of subparagraph 1 of paragraph (e) of subdivi-
     2  sion 5 of section 366 of the social services law is REPEALED.
     3    § 2. The opening paragraph of  subparagraph  3  of  paragraph  (e)  of
     4  subdivision  5  of section 366 of the social services law, as amended by
     5  section 14 of part MM of chapter 56 of the laws of 2020, is  amended  to
     6  read as follows:
     7    In determining the medical assistance eligibility of an institutional-
     8  ized individual, any transfer of an asset by the individual or the indi-
     9  vidual's spouse for less than fair market value made within or after the
    10  look-back  period  shall  render  the  individual ineligible for nursing
    11  facility services for the period of time specified in subparagraph  five
    12  of this paragraph. [In determining the medical assistance eligibility of
    13  a  non-institutionalized  individual,  any  transfer  of an asset by the
    14  individual or the individual's spouse for less than  fair  market  value
    15  made  within  or  after the look-back period shall render the individual
    16  ineligible for community based long term care services for the period of
    17  time specified in subparagraph five of this paragraph.] For purposes  of
    18  this paragraph:
    19    §  3.  Clause (vi) of subparagraph 1 of paragraph (e) of subdivision 5
    20  of section 366 of the social services law, as amended by section  13  of
    21  part  MM  of  chapter  56  of  the  laws  of 2020, is amended to read as
    22  follows:
    23    (vi) "look-back  period"  means  the  sixty-month  period  immediately
    24  preceding the date that an institutionalized individual is both institu-
    25  tionalized  and has applied for medical assistance[, or in the case of a
    26  non-institutionalized individual, subject to federal approval, the thir-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10787-01-3

        A. 9278                             2

     1  ty-month period immediately preceding the date  that  such  non-institu-
     2  tionalized  individual  applies  for medical assistance coverage of long
     3  term care services. Nothing herein precludes a review of eligibility for
     4  retroactive authorization for medical expenses incurred during the three
     5  months prior to the month of application for medical assistance].
     6    § 4. This act shall take effect immediately.
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