Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Assemblywoman LUANNE M. PETERPAUL
District 11 (Monmouth)
Assemblywoman GARNET R. HALL
District 28 (Essex and Union)
Co-Sponsored by:
Assemblywomen Donlon and Morales
SYNOPSIS
Increases income and resource threshold limit for certain Medicaid eligibility groups.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning income and resource eligibility under Medicaid and amending P.L.1968, c.412 and supplementing Title 30 of the Revised Statues.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 3 of P.L.1968, c.413 (C.30:4D-3) is amended to read as follows:
3. Definitions. As used in P.L.1968, c.413 (C.30:4D-1 et seq.), and unless the context otherwise requires:
a. "Applicant" means any person who has made application for purposes of becoming a "qualified applicant."
b. "Commissioner" means the Commissioner of Human Services.
c. "Department" means the Department of Human Services, which is herein designated as the single State agency to administer the provisions of this act.
d. "Director" means the Director of the Division of Medical Assistance and Health Services.
e. "Division" means the Division of Medical Assistance and Health Services.
f. "Medicaid" means the New Jersey Medical Assistance and Health Services Program.
g. "Medical assistance" means payments on behalf of recipients to providers for medical care and services authorized under P.L.1968, c.413.
h. "Provider" means any person, public or private institution, agency, or business concern approved by the division lawfully providing medical care, services, goods, and supplies authorized under P.L.1968, c.413, holding, where applicable, a current valid license to provide such services or to dispense such goods or supplies.
i. "Qualified applicant" means a person who is a resident of this State, and either a citizen of the United States or an eligible alien, and is determined to need medical care and services as provided under P.L.1968, c.413, with respect to whom the period for which eligibility to be a recipient is determined shall be the maximum period permitted under federal law, and who:
(1) Is a dependent child or parent or caretaker relative of a dependent child who would be, except for resources, eligible for the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act as of July 16, 1996;
(2) Is a recipient of Supplemental Security Income for the Aged, Blind and Disabled under Title XVI of the Social Security Act;
(3) Is an "ineligible spouse" of a recipient of Supplemental Security Income for the Aged, Blind and Disabled under Title XVI of the Social Security Act, as defined by the federal Social Security Administration;
(4) Would be eligible to receive Supplemental Security Income under Title XVI of the federal Social Security Act or, without regard to resources, would be eligible for the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act as of July 16, 1996, except for failure to meet an eligibility condition or requirement imposed under such State program which is prohibited under Title XIX of the federal Social Security Act such as a durational residency requirement, relative responsibility, consent to imposition of a lien;
(5) (Deleted by amendment, P.L.2000, c.71).
(6) Is an individual under 21 years of age who, without regard to resources, would be, except for dependent child requirements, eligible for the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act as of July 16, 1996, or groups of such individuals, including but not limited to, children in resource family placement under supervision of the Division of Child Protection and Permanency in the Department of Children and Families whose maintenance is being paid in whole or in part from public funds, children placed in a resource family home or institution by a private adoption agency in New Jersey or children in intermediate care facilities, including developmental centers for the developmentally disabled, or in psychiatric hospitals;
(7) Would be eligible for the Supplemental Security Income program, but is not receiving such assistance and applies for medical assistance only;
(8) Is determined to be medically needy and meets all the eligibility requirements described below:
(a) The following individuals are eligible for services, if they are determined to be medically needy:
(i) Pregnant women;
(ii) Dependent children under the age of 21;
(iii) Individuals who are 65 years of age and older; and
(iv) Individuals who are blind or disabled pursuant to either 42 C.F.R.435.530 et seq. or 42 C.F.R.435.540 et seq., respectively.
(b) The following income standard shall be used to determine medically needy eligibility:
(i) [For one person and two person households, the] The income standard shall be [the maximum allowable under federal law, but shall not exceed 133 1/3% of the State's payment level to two person households under the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act in effect as of July 16, 1996; and
(ii) For households of three or more persons, the income standard shall be set at 133 1/3% of the State's payment level to similar size households under the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act in effect as of July 16, 1996] 138 percent of the poverty level.
(c) The following resource standard shall be used to determine medically needy eligibility:
(i) For one person households, the resource standard shall be [200% of the resource standard for recipients of Supplemental Security Income pursuant to 42 U.S.C. s.1382(1)(B)] $40,000;
(ii) For two person households, the resource standard shall be [200% of the resource standard for recipients of Supplemental Security Income pursuant to 42 U.S.C. s.1382(2)(B)] $60,000;
(iii) For households of three or more persons, the resource standard in subparagraph (c)(ii) above shall be increased by [$100.00] $20,000 for each additional pe