This bill introduces provisional eligibility for Medicaid nursing facility services as part of the long-term care application process, allowing individuals to receive care while their applications are being processed. Specifically, 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. The bill also stipulates that provisional eligibility will last for 18 months unless terminated due to a final determination on the application. Additionally, it requires nursing facilities to reimburse the department for payments made during the provisional eligibility period once a final decision is reached.

To support this initiative, the bill appropriates $1,500,000 to the Department of Health and Human Services for the biennium ending June 30, 2027, to cover provisional eligibility expenses. It also establishes two positions within the department to manage the program and includes provisions for additional funding if expenditures exceed appropriated amounts. Furthermore, the bill amends existing law to clarify that counties will not be liable for payments related to provisional eligibility. Overall, the bill aims to streamline access to long-term care services while ensuring financial accountability for nursing facilities.

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