Senate Bill No. 370–Committee on Human Resources
and Facilities

March 11, 1999

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Referred to Committee on Human Resources and Facilities

 

SUMMARY—Provides contingently for combination of Medicaid with private insurance. (BDR 38-1496)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State or on Industrial Insurance: Yes.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to public assistance to the medically indigent; providing contingently for a combination of Medicaid with private insurance for long-term care; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. Chapter 422 of NRS is hereby amended by adding thereto a

1-2 new section to read as follows:

1-3 1. The administrator shall negotiate with private insurers, and seek

1-4 assistance from private charitable foundations, to arrange for the

1-5 availability at a reasonable cost of insurance to cover the cost of an

1-6 initial period of long-term care for which the state is responsible

1-7 pursuant to NRS 422.272 to pay the nonfederal portion.

1-8 2. The administrator shall negotiate with the appropriate federal

1-9 authorities to obtain a waiver, if necessary, to permit the state to establish

1-10 such a program and to permit the state to forego the recovery of benefits

1-11 paid for long-term care described in subsection 1 from the estate of a

1-12 patient whose insurance paid or would have paid for at least 2 years of

1-13 that care.

1-14 Sec. 2. NRS 422.272 is hereby amended to read as follows:

1-15 422.272 1. The administrator shall include in the state plan for

1-16 Medicaid a requirement that the state shall pay the nonfederal share of

1-17 expenditures for the medical, administrative and [transaction] transactional

1-18 costs , to the extent not covered by private insurance, of a person:

2-1 (a) Who is admitted to a hospital, facility for intermediate care or

2-2 facility for skilled nursing for not less than 30 consecutive days;

2-3 (b) Who is covered by the state plan for Medicaid; and

2-4 (c) Whose net countable income per month is not more than $775 or 156

2-5 percent of the supplemental security income benefit rate established

2-6 pursuant to 42 U.S.C. § 1382(b)(1), whichever is greater.

2-7 2. As used in this section:

2-8 (a) "Facility for intermediate care" has the meaning ascribed to it in

2-9 NRS 449.0038.

2-10 (b) "Facility for skilled nursing" has the meaning ascribed to it in NRS

2-11 449.0039.

2-12 (c) "Hospital" has the meaning ascribed to it in NRS 449.012.

2-13 Sec. 3. NRS 422.2935 is hereby amended to read as follows:

2-14 422.2935 1. Except as otherwise provided in this section, the welfare

2-15 division shall, to the extent it is not prohibited by federal law and when

2-16 circumstances allow:

2-17 (a) Recover benefits correctly paid for Medicaid from:

2-18 (1) The undivided estate of the person who received those benefits;

2-19 and

2-20 (2) Any recipient of money or property from the undivided estate of

2-21 the person who received those benefits.

2-22 (b) Recover from the recipient of Medicaid or the person who signed the

2-23 application for Medicaid on behalf of the recipient an amount not to exceed

2-24 the benefits incorrectly paid to the recipient if the person who signed the

2-25 application:

2-26 (1) Failed to report any required information to the welfare division

2-27 which he knew at the time he signed the application; or

2-28 (2) Failed within the period allowed by the welfare division to report

2-29 any required information to the welfare division which he obtained after he

2-30 filed the application.

2-31 2. The welfare division shall not recover benefits pursuant to paragraph

2-32 (a) of subsection 1 [, except] :

2-33 (a) If the expenses of long-term care for the person who received the

2-34 benefits were paid or would have been paid for at least 2 years under a

2-35 policy of private insurance.

2-36 (b) Except from a person who is neither a surviving spouse nor a child,

2-37 until after the death of the surviving spouse, if any, and only at a time when

2-38 the person who received the benefits has no surviving child who is under 21

2-39 years of age or is blind or permanently and totally disabled.

2-40 3. Except as otherwise provided by federal law, if a transfer of real or

2-41 personal property by a recipient of Medicaid is made for less than fair

2-42 market value, the welfare division may pursue any remedy available

2-43 pursuant to chapter 112 of NRS with respect to the transfer.

3-1 4. The amount of Medicaid paid to or on behalf of a person is a claim

3-2 against the estate in any probate proceeding only at a time when there is no

3-3 surviving spouse or surviving child who is under 21 years of age or is blind

3-4 or permanently and totally disabled.

3-5 5. The administrator may elect not to file a claim against the estate of a

3-6 recipient of Medicaid or his spouse if he determines that the filing of the

3-7 claim will cause an undue hardship for the spouse or other survivors of the

3-8 recipient. The administrator shall adopt regulations defining the

3-9 circumstances that constitute an undue hardship.

3-10 6. Any recovery of money obtained pursuant to this section must be

3-11 applied first to the cost of recovering the money. Any remaining money

3-12 must be divided among the Federal Government, the department and the

3-13 county in the proportion that the amount of assistance each contributed to

3-14 the recipient bears to the total amount of the assistance contributed.

3-15 7. An action to recover money owed to the department of human

3-16 resources as a result of the payment of benefits for Medicaid must be

3-17 commenced within 6 months after the cause of action accrues. A cause of

3-18 action accrues after all [of] the following events have occurred:

3-19 (a) The death of the recipient of Medicaid;

3-20 (b) The death of the surviving spouse of the recipient of Medicaid;

3-21 (c) The death of all children of the recipient of Medicaid who are blind

3-22 or permanently and totally disabled as determined in accordance with 42

3-23 U.S.C. § 1382c; and

3-24 (d) The arrival of all other children of the recipient of Medicaid at the

3-25 age of 21 years.

3-26 Sec. 4. NRS 422.29355 is hereby amended to read as follows:

3-27 422.29355 1. The welfare division may, except to the extent [not]

3-28 prohibited by federal law [,] or pursuant to NRS 422.2935, petition for the

3-29 imposition of a lien pursuant to the provisions of NRS 108.850 against real

3-30 or personal property of a recipient of Medicaid as follows:

3-31 (a) The welfare division may obtain a lien against a recipient’s property,

3-32 both real or personal, before or after his death in the amount of assistance

3-33 paid or to be paid on his behalf if the court determines that assistance was

3-34 incorrectly paid for the recipient.

3-35 (b) The welfare division may seek a lien against the real property of a

3-36 recipient at any age before his death in the amount of assistance paid or to

3-37 be paid for him if he is an inpatient in a nursing facility, intermediate care

3-38 facility for the mentally retarded or other medical institution and the

3-39 welfare division determines, after notice and opportunity for a hearing in

3-40 accordance with its regulations, that he cannot reasonably be expected to be

3-41 discharged and return home.

3-42 2. No lien may be placed on a recipient’s home for assistance correctly

3-43 paid if:

4-1 (a) His spouse;

4-2 (b) His child who is under 21 years of age or blind or permanently and

4-3 totally disabled as determined in accordance with 42 U.S.C. § 1382c; or

4-4 (c) His brother or sister who is an owner or part owner of the home and

4-5 who was residing in the home for at least 1 year immediately before the

4-6 date the recipient was admitted to the medical institution,

4-7 is lawfully residing in the home.

4-8 3. Upon the death of a recipient the welfare division may seek a lien

4-9 upon his undivided estate as defined in NRS 422.054.

4-10 4. The state welfare administrator shall release a lien pursuant to this

4-11 section:

4-12 (a) Upon notice by the recipient or his representative to the

4-13 administrator that the recipient has been discharged from the medical

4-14 institution and has returned home;

4-15 (b) If the lien was incorrectly determined; or

4-16 (c) Upon satisfaction of the welfare division’s claim.

4-17 Sec. 5. 1. This section and section 1 of this act become effective on

4-18 July 1, 1999.

4-19 2. Sections 2, 3 and 4 of this act become effective on the date that the

4-20 state is permitted, through the negotiation required by section 1 of this act

4-21 or through change in federal law, to forego the recovery of benefits as

4-22 provided in those sections.

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