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, and establishes two positions to manage the provisional eligibility program. It also includes provisions that exempt counties from liability for provisional eligibility payments and allows the department to request additional funding if expenditures exceed appropriated amounts. The bill aims to streamline the long-term care application process and ensure that individuals can access necessary services while awaiting approval.

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