This bill introduces provisional eligibility for Medicaid nursing facility services as part of the long-term care application process. It mandates that the Department of Health and Human Services grant provisional eligibility within 90 days of receiving an application, regardless of whether the application is complete, provided that the nursing facility agrees to comply with the contract terms. The provisional eligibility will last for 18 months unless a final determination is made sooner, and it allows for payments to be made at the same rate as fully eligible individuals. Additionally, the bill stipulates that if the application is not approved within 12 months, the care provider may initiate an action for a special Medicaid representative.

The bill also includes an appropriation of $1,500,000 for the biennium ending June 30, 2027, to fund provisional eligibility expenses. It specifies that counties will not be liable for these provisional eligibility payments and establishes two positions within the Department of Health and Human Services to manage the program. The bill further allows the commissioner to request additional funding if expenditures exceed appropriated amounts, with the governor authorized to draw from the treasury for this purpose. The effective date for this act is set for July 1, 2025.

Statutes affected:
Introduced: 167:8, 167:18-a