hb1473_Sen_ctee_sub_LC_33_1542S

hb1473_Sen_ctee_sub_LC_33_1542S_5.html

06 LC 33 1542S

The Senate Appropriations Committee offered the following substitute to HB 1473:

A BILL TO BE ENTITLED
AN ACT

To amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally, so as to require prior legislative approval for the submission of certain waivers pursuant to Section 1115 of the federal Social Security Act; to provide for a limit on the effective date of the Medicaid estate recovery program; to provide for substantial and unreasonable hardship waivers when the estate of the Medicaid recipient is valued at $100,000.00 or less; to provide for notice requirements; to provide for installment payments; to provide for submission of an amendment to the state plan; to provide for an effective date; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally, is amended by adding a new Code section to read as follows:

"49-4-142.1.

On and after the effective date of this Code section, neither the department, the board, nor any other representative of the state shall submit any request to the United States Department of Health and Human Services Centers for Medicare and Medicaid Services for a waiver pursuant to Section 1115 of the federal Social Security Act without prior legislative approval. This shall only apply to waivers that relate to Medicaid modernization, Medicaid transformation, or a Medicaid reform model that would affect 20,000 or more individuals in Georgia Medicaid population. The prior legislative approval required under this Code section shall be by Act of the General Assembly or the adoption of a joint resolution of the General Assembly."

SECTION 2.

Said article is further amended by striking Code Section 49-4-147.1, relating to claims by the department against the estate of Medicaid recipients, and inserting in lieu thereof the following:

"49-4-147.1.

(a) In accordance with applicable federal law and regulations, including those under Title XIX of the federal Social Security Act, the department may make claim against the estate of a Medicaid recipient for the amount of any medical assistance payments made on such persońs behalf by the department. A claim shall be made against the estate of a deceased Medicaid recipient only if at the time of application for medical assistance, the applicant received written notice that the medical assistance costs could be recovered from the applicant́s estate and the applicant signed a written acknowledgment of receipt of such notice, the estate is otherwise subject to recovery, if no hardship or other exemption exists. The commissioner shall waive such claim if he or she determines enforcement of the claim would result in substantial and unreasonable hardship to dependents of the individual against whose estate the claim exists.

(b) The estate recovery program established pursuant to this Code section shall not be effective any earlier than the effective date of this subsection. In no event shall the department make claims against the estate of a Medicaid recipient for the amount of any medical assistance payments made on such persońs behalf prior to the effective date of this subsection.

(c) The commissioner shall delay execution of a claim against the estate where the dependents or heirs agree to pay the full amount of the claim in reasonable installments.

(d) A substantial and unreasonable hardship shall include, but not be limited to, estates of Medicaid recipients that are valued at $100,000.00 or less. The value of the estate shall not include yeaŕs support, funeral expenses not to exceed $5,000.00, necessary expenses of administration, or reasonable expenses of the recipient́s last illness. No later than July 1, 2006, the department shall submit an amendment to the state plan with the United States Department of Health and Human Services Centers for Medicare and Medicaid Services reflecting the provisions of this subsection. In the event that such amended state plan is not approved, this subsection shall stand repealed in its entirety."

SECTION 3.

This Act shall become effective upon its approval by the Governor or upon its becoming law without such approval.

SECTION 4.

All laws and parts of laws in conflict with this Act are repealed.