HOUSE OF REPRESENTATIVES

H.B. NO.

2864

TWENTY-SIXTH LEGISLATURE, 2012

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346-    Presumptive eligibility under medicaid for waitlisted patients.  (a)  The department shall presume that a waitlisted patient applying for medicaid is eligible for coverage; provided that the applicant is able to show proof of:

     (1)  An annual income at or below the maximum level allowed under federal law or under a waiver approved for Hawaii under 42 United States Code section 1396n, as applicable;

     (2)  Verification of assets;

     (3)  Confirmation of waitlisted status as certified by a health care provider licensed in Hawaii; and

     (4)  Meeting the level of care requirement for institutional or home- and community-based long-term care as determined by a physician licensed in Hawaii.

The department shall notify the applicant and the facility of the presumptive eligibility on the date of receipt of the application.  The applicant shall submit the remaining documents necessary to qualify for medicaid coverage within ten business days after the applicant's receipt of notification of presumptive eligibility from the department.  The department shall notify the applicant of eligibility within five business days of receipt of the completed application for medicaid coverage.

     Waitlisted patients who are presumptively covered by medicaid shall be eligible for services and shall be processed for coverage under the State's qualifying medicaid program.

     (b)  If the waitlisted patient is later determined to be ineligible for medicaid after receiving services during the period of presumptive eligibility, the department shall disenroll the patient and notify the provider and the plan, if applicable, of disenrollment by facsimile transmission or electronic mail.  The department shall provide reimbursement to the provider or the plan for the time during which the waitlisted patient was enrolled."

     SECTION 2.  The department of human services shall submit a report to the legislature no later than twenty days prior to the convening of the regular sessions of 2013 through 2017, inclusive, of findings and recommendations regarding the costs and other issues related to medicaid presumptive eligibility.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $200,000 or so much thereof as may be necessary for fiscal year 2012-2013 to cover the cost of any reimbursements made to providers or plans for services provided during the time waitlisted patients are enrolled but eventually determined to be ineligible.

     The sum appropriated shall be expended by the department of human services for the purposes of this Act.

     SECTION 4.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect on July 1, 2012, and shall be repealed on July 1, 2017.

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Medicaid; Presumptive Eligibility; Long-Term Care

 

Description:

Grants presumptive eligibility to medicaid-eligible patients who have been waitlisted for long-term care.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.