Bill Summary – FastDemocracy

8087.01000
     Sixty-sixth
     Legislative Assembly                    HOUSE BILL NO. 1115
     of North Dakota
     Introduced by
       Human Services Committee
       (At the request of the Department of Human Services)
  A BILL for an Act to create and enact a new section to chapter 12-44.1, a new section to chapter
  50-10.2, and a new section to chapter 50-24.1 of the North Dakota Century Code, relating to
  payment of claims received on behalf of inmates, furnishing financial information to a facility,
  and definitions for medical assistance for needy persons; to amend and reenact subsection 6 of
  section 50-06-01.9 and sections 50-24.1-01.1, 50-24.1-01.3, 50-24.1-02, 50-24.1-02.1,
  50-24.1-02.2, 50-24.1-02.3, 50-24.1-02.5, 50-24.1-02.6, 50-24.1-02.7, 50-24.1-02.8,
  50-24.1-02.10, 50-24.1-03.1, 50-24.1-03.2, 50-24.1-03.3, 50-24.1-04, 50-24.1-07, 50-24.1-12,
  50-24.1-16, 50-24.1-17, 50-24.1-18, 50-24.1-18.1, 50-24.1-20, 50-24.1-24, 50-24.1-26,
  50-24.1-28, 50-24.1-29, 50-24.1-30, 50-24.1-31, 50-24.1-33, 50-24.1-35, 50-24.1-36, and
 50-24.1-39 of the North Dakota Century Code, relating to criminal history record checks on
 Medicaid services applicants, providers, and staff members and medical assistance for needy
 persons; and to repeal sections 50-24.1-01.2, 50-24.1-10, 50-24.1-11, 50-24.1-13, 50-24.1-19,
 50-24.1-22, 50-24.1-25, 50-24.1-27, 50-24.1-34, and 50-24.1-38 of the North Dakota Century
 Code, relating to medical assistance for needy persons.
 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
     SECTION 1. A new section to chapter 12-44.1 of the North Dakota Century Code is created
 and enacted as follows:
     Payment of claims received on behalf of inmates.
     Each county shall pay health care providers for services received by inmates at the fee
 schedule established by the department of human services for the medical assistance program.
 The county jail and health care provider are responsible for the billing and payment processes.
     SECTION 2. AMENDMENT. Subsection 6 of section 50-06-01.9 of the North Dakota
 Century Code is amended and reenacted as follows:
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      6.   Medicaid services applicant providers, Medicaid services providers, staff members of
           the applicant provider or provider, or an individual with a five percent or more direct or
           indirect ownership interest in the applicant provider or provider under chapter 50-24.1.
      SECTION 3. A new section to chapter 50-10.2 of the North Dakota Century Code is created
  and enacted as follows:
      Furnishing financial information.
      A facility may request that an applicant for admission, a resident of the facility, or the
  applicant's or resident's legal representative furnish financial information regarding income and
  assets, including information regarding any transfers or assignments of income or assets. A
 facility may deny admission to an applicant for admission who is unable to verify a viable
 payment source.
     SECTION 4. A new section to chapter 50-24.1 of the North Dakota Century Code is created
 and enacted as follows:
     Definition.
     As used in this chapter, unless the context otherwise requires:
     1.   "Department" means the department of human services.
     2.   "Medical assistance" means benefits paid under chapter 50-24.1 and title XIX of the
          Social Security Act [42 U.S.C. 1396 et seq.].
     3.   "Third party" means an individual, entity, or program that is or may be liable to pay all
          or part of the expenditures for medical assistance furnished under this chapter.
     SECTION 5. AMENDMENT. Section 50-24.1-01.1 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-01.1. Department to submit plans and seek waivers.
     The department of human services may submit state plans in forms that are consistent with
 and which meet requirements for such plans which are or may be imposed under the Medicare
 Catastrophic Coverage Act of 1988 [Pub. L. 100-360; 102 Stat. 729; 42 U.S.C. 1396a et seq.,
 as amended]. The departmentand may take such actions as are reasonably necessary to
 conform the administration ofadminister programs under its supervision and direction to the
 requirements of the Medicare Catastrophic Coverage Act of 1988 and the state plans submitted
 thereunder, including the issuance of policy manuals, forms, and program directives. The
 department may publish dashboards that demonstrate program utilization and provider care
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  trends. Within the limits of legislative appropriation, the department may seek appropriate
  waivers of the requirements of the federal statutes or regulations as authorized by federal law.
      SECTION 6. AMENDMENT. Section 50-24.1-01.3 of the North Dakota Century Code is
  amended and reenacted as follows:
      50-24.1-01.3. Department to comply with federal requirements - Interagency
  cooperation - Civil money penalty fund.
      1.   The department of human services shall take any action necessary to comply with the
           requirements of section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)],
           including establishing a process to enforce compliance by nursing facilities with
          requirements for participation in the medical assistance program that conforms to any
          federal regulations implementing that section.
     2.   The state department of health and the department of human services shall cooperate
          to achieve prompt and effective implementation of subsection 1.
     3.   The state treasurer shall establish a fund for the receipt of any civil money penalties
          imposed under subsection 1. Any civil money penalty paid to the department of human
          services under subsection 1 must be deposited in that fund and, subject to the limits of
          legislative appropriation, may be expended for the sole purpose of the protection of
          the health or property of residents of nursing facilities that the state orallowed by the
          federal government finds deficient.
     4.   This section may not be construed to create any right or authorize any activity not
          provided for in section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)]
          or its implementing federal regulations.
     5.   Before the establishment and assessment of civil money penalties permitted by
          section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)], the department
          of human services is encouraged to submit a plan of alternative remedies in
          accordance with section 1919(h)(2)(B)(ii) of that Act.
     SECTION 7. AMENDMENT. Section 50-24.1-02 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02. Eligibility.
     Within the limits of legislative appropriations, medical assistance may be paid for any
 person who either has income and resources insufficient to meet the costs of necessary
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  medical care and services or is eligible for or receiving financial assistance under chapter 50-09
  or title XVI of the Social Security Act, as amended, and:
      1.   Has not at any time before or after making application for medical assistance made an
           assignment or transfer of property for the purpose of rendering that person eligible for
           assistance under this chapter. For the purposes of making any determination or
           redetermination of eligibility, the phrase "assignment or transfer" includes actions or
           failures to act which effect a renunciation or disclaimer of any interest which the
           applicant or recipient might otherwise assert or have asserted, or which serve to
           reduce the amounts which an applicant or recipient might otherwise claim from a
          decedent's estate, a trust or similar device, or a person obligated by law to furnish
          support to the applicant or recipient.
     2.   Has applied or agrees to apply all proceeds received or receivable by that person or
          that person's eligible spouse from automobile accident medical benefits coverage and
          private health carethird-party medical coverage, including health care coverage,
          accident insurance, and automobile insurance, to the costs of medical care for that
          person and that person's eligible spouse and children. The department of human
          services may require from any applicant or recipient of medical assistance the
          assignment of any rights accruing under automobile medical benefits coverage or
          private health carethird-party medical coverage. Any rights or amounts so assigned
          must be applied against the cost of medical care paid on behalf of the recipient under
          this chapter. The assignment is not effective as to any carrier before the receipt of
          notice of assignment by such carrier.
     3.   Is eligible under rules and regulations established by the department of human
          services.
     SECTION 8. AMENDMENT. Section 50-24.1-02.1 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02.1. Assignment of claim.
     1.   Each applicant or recipient of benefits under this chapter must be deemed to have
          assigned, to the department of human services, any right of recovery the applicant or
          recipient may have for medical costs incurred under this chapter not exceeding the
          amount of funds expended by the department for the care and treatment of the
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            applicant or recipient. The applicant or recipient, or other person empowered by law to
            act in the applicant's or recipient's behalf, shall execute and deliver an assignment of
            claim, assignment of rights, or other authorizations as necessary to secure fully the
            right of recovery of the department. The assignment:
            a.       Is effective as to both current and accrued medical support recovery obligations.
            b.       Takes effect upon a determination that an applicant is eligible for assistance
                     under this chapter.
       2.   The department of human services may compromise claims arising out of
            assignments made under this section on such terms as it may deem just and
           appropriate. The department of human services may not be compelled to compromise
           any claim.
     SECTION 9. AMENDMENT. Section 50-24.1-02.2 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02.2. Community spouse resource allowance.
     In determining eligibility for medical assistance applicants and recipients, the department of
 human services shall establish a community spouse resource allowance equalup to the
 maximum community spouse resource allowance as provided by 42 U.S.C. 1396r-5(f)(2). This
 section applies to a community spouse of an institutionalized spouse. For purposes of this
 section, "institutionalized spouse" includes an individual who is described in 42 U.S.C. 1396a(a)
 (10)(A)(ii)(VI).
     SECTION 10. AMENDMENT. Section 50-24.1-02.3 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02.3. When designated pre-need funeral service contracts, prepayments, or
 deposits not to be considered in eligibility determination.
     In determining eligibility for medical assistance, the department of human services may not
 consider as an available resource any pre-need funeral service contracts, prepayments, or
 deposits to a fund which total six thousand dollars or less designated by the applicant or
 recipient as set-aside to pay for the applicant's or recipient's funeral. An applicant or recipient
 designates a prepayment or deposit for that applicant's or recipient's burial by providing funds
 that are to be used for the funeral or burial expenses of the applicant or recipient. If an
 applicant's or recipient's burial is funded by an insurance policy, the amount considered
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  set-aside for burial is the lesser of the cost basis or the face value of the insurance policy. In
  addition, the applicant or recipient may designate all or a portion of the three thousand dollar
  asset limitation for funeral pre-need contracts, prepayments, or deposits. Interest or earnings
  retained in a funeral fund also may not be considered as an available resource. A pre-need
  funeral service contract, prepayment, or deposit designated under this section is not a
  multiple-party account for purposes of chapter 30.1-31. Any amount in a pre-need funeral
  service contract, prepayment, or deposit designated under this section which is not used for
  funeral or burial expenses must be returned to the estate of the medical assistance recipient
  and is subject to recovery by the department from the medical assistance recipient's estate. No
 claim for payment of funeral expenses may be made against the estate of a deceased medical
 assistance recipient except to the extent that funds maintained in accordance with this section
 total less than six thousand dollars.
     SECTION 11. AMENDMENT. Section 50-24.1-02.5 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02.5. Effect of purchase of insurance on disqualifying transfer.
     1.    An individual who secures and maintains insurance that covers the cost of
           substantially all necessary medical care, including necessary care in a nursing home
           and necessary care for an individual who qualifies for admission to a nursing home but
           receives care elsewhere, for at least thirty-six months after the date an asset is
           disposed of, may demonstrate that the asset was disposed of exclusively for a
           purpose other than to qualify for medical assistance by providing proof of that
           insurance.
     2.    If purchased after July 31, 2003, the insurance coverage under this section must
           include home health care coverage, assisted living coverage, basic care coverage,
           and skilled nursing facility coverage. The coverage required under this subsection
           must include a daily benefit equal to at least one and fifty-seven hundredths times the
           average daily cost of nursing care for the year in which the policy was issued and an
           aggregate benefit equal to at least one thousand ninety-five times that daily benefit.
     3.    This section applies only to policies purchased before the effective date of an
           approved amendment to the state plan for medical assistance that provides for a
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           qualified state long-term care insurance partnership under section 1917(b) of the
           Social Security Act [42 U.S.C. 1396p].
      4.   The department of human services shall certify to the legislative council the effective
           date described in subsection 3.
      SECTION 12. AMENDMENT. Section 50-24.1-02.6 of the North Dakota Century Code is
  amended and reenacted as follows:
      50-24.1-02.6. Medical assistance benefits - Eligibility criteria.
      1.   The department shall provide medical assistance benefits to otherwise eligible
           persons who are:
          a.   Medically medically needy persons who have countable income that does not
               exceed an amount determined under subsection 2; and
          b.   Minors who have countable income that does not exceed an amount determined
               under subsection 3.
     2.   The department of human services shall establish an income level for medically needy
          persons at an amount, no less than required by federal law, that, consistent with the
          requirements of subsection 3, is the greatest income level achievable without
          exceeding legislative appropriations for that purpose.
     3.   The department of human services shall establish income levels for minors, based on
          the age of the minors, at amounts, no less than required by federal law.
     4.   The department of human services shall provide medical assistance benefits to
          children and families coverage groups and pregnant women without consideration of
          assets.
     4.   The department may require, as a condition of eligibility, individuals eligible for
          Medicare part A, B, or D to apply for such coverage.
     SECTION 13. AMENDMENT. Section 50-24.1-02.7 of the North Dakota Century Code is
 amended and reenacted as follows:
     50-24.1-02.7. Workers with disabilities coverage.
     The department of human services shall establish and implement a buyin program to
 provide medical assistance to an individual who, except for substantial gainful activity, meets
 the definition of disabled under the supplemental security income program under title XVI of the
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