This bill amends the eligibility criteria for Medicaid services related to nursing facilities and home and community-based care. Key updates include the addition of "mobility" to the list of activities of daily living for which assistance is required, and a correction to the federal reference for the definition of "skilled professional medical personnel" from 42 C.F.R. section 432.50(d)(1)(ii) to 432.2. The bill also clarifies that the responsibility for medical eligibility determination lies with skilled professional medical personnel and mandates that the department staff can obtain necessary medical information for the eligibility decision-making process.

Furthermore, the bill stipulates that if skilled professional medical personnel cannot determine an applicant's eligibility, the department must seek a determination from the applicant's primary care physician or nurse practitioner. It emphasizes the importance of considering clinical information from other healthcare providers and requires that no applicant be denied eligibility for annual redetermination without the agreement of their primary care physician or nurse practitioner. The act will take effect 60 days after its passage.

Statutes affected:
Introduced: 151-E:3