Relates to directing the department of health to submit an amendment to the plan for medical assistance

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.

Existing law

New bill.

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

This is a new bill.

Fiscal implications

None.

Local fiscal implications

None.

Effective date

The bill would take effect immediately.