BILL NUMBER:S3199

TITLE OF BILL:
An act
to amend the social services law and the
insurance law, in relation to
directing the department of health to submit an amendment to the plan
for medical assistance; and to direct the department of insurance to
adopt any necessary conforming amendments to regulations or other rules

PURPOSE:
To permit policyholders of the New York State Partnership for
Long-Term Care to be eligible for Medicaid asset protection
regardless of their state of residence when they apply for long term
care Medicaid assistance.

SUMMARY OF PROVISIONS:
Amend section 367-f of the social services law to direct the New York
State Department of Health to apply to the Federal Department of
Health and Human Services for uniform reciprocal recognition of
long-term care insurance policies purchased under New York State
long-term care insurance Partnerships. Amend section 3229 of the
insurance law to direct the Superintendent of Insurance to adopt
appropriate rules or regulations to ensure uniformity with Federal
standards relating to reciprocal recognition of long-term care
insurance Partnership policies.
              

JUSTIFICATION:
The New York State Partnership for Long-Term Care is a unique program
combining long-term care insurance and Medicaid Extended Coverage.
Its purpose is to help New Yorkers financially prepare for the
possibility of someday needing nursing home care, home care or
assisted living services. The program allows New Yorkers to protect
some or all of their assets depending on the partnership insurance
plan purchased, if their long-term care needs extend beyond the
period covered by their private insurance policy.

If an individual buys New York State Partnership for Long-Term Care
insurance from a participating insurer, uses the benefits according
to the conditions of the program, that individual
can apply for New York State Medicaid Extended Coverage which may
assist in paying for ongoing care. However, under current law, an
individual with such a policy can apply and remain eligible for
Medicaid Extended Coverage only as long as the individual applies for
Medicaid in the State of New York.

New York, along with Connecticut, Indiana and California were original
participants in the LTC Partnership program supported by the Robert
Wood Johnson Foundation. In 1993 Congress prohibited other states
from enacting similar programs. The Partnership Program was expanded
under the Federal Deficit Reduction Act (DRA) of 2005, enabling other
states to set up LTC Partnership programs. Those new Partnership
programs now permit policyholder reciprocity, which means that they
may apply for Medicaid in any of the reciprocal Partnership states
and receive the same Medicaid asset protection benefits as they would
have within their home state.


The DRA required the Federal Department of Health and Human Services
(HHS) to develop standards for such reciprocity.

With this legislation enacted, if a New York resident purchases a
Partnership policy and then later moves to Florida and uses his
policy in a Florida nursing home, he or she could seek
asset protection benefits from the Florida Medicaid Program. The same
would be true for Florida Partnership policyholders who relocate to
New York and then apply for Medicaid in New York.
This legislation requires New York to opt in to HHS's uniform
reciprocal recognition of long-term care insurance policies purchased
under state long-term care Partnerships, enabling individuals with
Partnership policies to move to another Partnership state without fear
of losing the additional Medicaid benefits or coverage.

LEGISLATIVE HISTORY:
S.3833 of 2009 & 2010 - Duane - Referred to Health
S.7237 of 2008 - Hannon - Referred to Health

FISCAL IMPLICATIONS:
Enactment of this legislation would allow New York residents to
relocate to other Partnership states and remain eligible for Medicaid
Extended Coverage from that state. In addition, it would allow
individuals from other Partnership states that move to New York to
receive Medicaid Extended Coverage as well. It is projected that the
fiscal impact will be the status quo and there will be no further
costs to New York.

EFFECTIVE DATE:
The bill would take effect immediately.