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