Connecticut 2021 Regular Session Status: In Committee

SB 913 — AN ACT REQUIRING FAIRNESS FOR FAMILIES IN MEDICAID ELIGIBILITY AND REIMBURSEMENT DETERMINATIONS.

Last action — REF. BY SEN. TO COMM. ON Appropriations

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

326 added · 224 removed

326 line(s) added, 224 removed.

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General Assembly Raised Bill No.
Senate General Assembly File No.
913 January Session, 2021 LCO No.
131 January Session, 2021 Substitute Senate Bill No.
3527 Referred to Committee on HUMAN SERVICES Introduced by:
913 Senate, March 24, 2021 The Committee on Human Services reported through SEN.
(HS) AN ACT REQUIRING FAIRNESS FOR FAMILIES IN MEDICAID ELIGIBILITY AND REIMBURSEMENT DETERMINATIONS.
MOORE of the 22nd Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.
AN ACT REQUIRING FAIRNESS FOR FAMILIES IN MEDICAID ELIGIBILITY AND REIMBURSEMENT DETERMINATIONS.
(NEW) (Effective July 1, 2021) The Commissioner of Social Services shall set payment rates for family caregivers authorized to receive compensation in programs administered by the Department of Social Services equal to the rates set for nonfamily professional caregivers providing the same types of services to participants in such programs, including, but not limited to, providing family caregivers rates received by personal care attendants negotiated pursuant to section 17b-706b of the general statutes and rates received by providers ofhome care servicespursuant to section17b-343ofthegeneralstatutes.
(NEW) (Effective July 1, 2021) To the extent permissible under federal law, payment rates for family caregivers authorized to receive compensation in programs administered by the Department of Social Services shall be equal to the rates set for nonfamily professional caregivers providing the same types of services to participants in such programs.
The commissioner shall also use such rates to determine the value of services provided by a family caregiver to a Medicaid applicant who transferred assets to the family caregiver as part of a legally enforceable compensation agreement with such caregiver.
The Commissioner of Social Services shall use the fair market value ofservicesprovidedby afamily caregiver indetermining whether a Medicaid applicant who transferred assets to such caregiver as part of a legally enforceable compensationagreement for suchservices violated any provision of federal law regarding the transfer of assets.
Subsection (h) of section 17b-342 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, LCO No.
Subsection (h) of section 17b-342 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2021):
3527 1 of 7 Raised Bill No.913 2021):
sSB913 / File No.
(h) An individual who is otherwise eligible for services pursuant to this section shall, as a condition of participation in the program, apply for medical assistance benefits pursuant to section 17b-260 when requested to do so by the department and shall accept such benefits if determined eligible.
131 1 sSB913 File No.
The Commissioner of Social Services shall provide medical assistance payments for Medicaid-eligible home care services retroactive to not more than three months before the date an eligible individual applied for Medicaid, to the extent permissible under 42 CFR 435.915, as amended from time to time.
131 (h) An individual who is otherwise eligible for services pursuant to this section shall, as a condition of participation in the program, apply for medical assistance benefits pursuant to section 17b-260 when requested to do so by the department and shall accept such benefits if determined eligible.
Any Medicaid applicant who has transferred assets for less than fair market value for purposes of obtaining or maintaining Medicaid eligibility in the sixty months before applying shall not be eligible for retroactive medical assistance payments.
The Commissioner of Social Services shall provide medical assistance payments for Medicaid-eligible home care services retroactive to not more than three months before the date an eligible individual applied for Medicaid, to the extent permissible under 42 CFR 435.915, as amended from time to time, provided such individual was otherwise eligible for Medicaid not more than three months before applying for Medicaid.
Any Medicaid applicant who has transferred assets for less than fair market value for purposes of obtaining or maintaining Medicaid eligibility in the sixty months before applying for Medicaid shall not be eligible for retroactive medical assistance payments.
Any disposition of property made on behalf of an applicant or recipient or the spouse of an applicant or LCO No.
Any disposition of property made on behalf of an applicant or recipient or the spouse of an applicant or sSB913 / File No.
3527 2 of 7 Raised Bill No.913 recipient by a guardian, conservator, person authorized to make such disposition pursuant to a power of attorney or other person so authorized by law shall be attributed to such applicant, recipient or spouse.
131 2 sSB913 File No.
131 recipient by a guardian, conservator, person authorized to make such disposition pursuant to a power of attorney or other person so authorized by law shall be attributed to such applicant, recipient or spouse.
The Commissioner of Social Services shall provide applicants for assistance under this section, at the time of application, with a written statement advising them of (1) the effect of an assignment or transfer or other disposition of property on eligibility for benefits or assistance, (2) the effect that having income that exceeds the limits prescribed in this subsection will have with respect to program eligibility, and (3) the LCO No.
The Commissioner of Social Services shall provide applicants for assistance under this section, at the time of application, with a written statement advising them of (1) the effect of an assignment or transfer or other disposition of property on eligibility for benefits or assistance, (2) the effect that having income that exceeds the limits prescribed in this subsection will have with respect to program eligibility, and (3) the sSB913 / File No.
3527 3 of 7 Raised Bill No.913 availability of, and eligibility for, services provided by the Nurturing Families Network established pursuant to section 17b-751b.
131 3 sSB913 File No.
131 availability of, and eligibility for, services provided by the Nurturing Families Network established pursuant to section 17b-751b.
For purposes of determining whether a beneficiary under a specialneedstrust,who hasnot receivedadisability determination from the Social Security Administration, is disabled, as defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or the commissioner's designee, shall independently make such LCO No.
For purposes of determining whether a beneficiary under a specialneedstrust,who hasnot receivedadisability determination from the Social Security Administration, is disabled, as defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or the commissioner's designee, shall independently make such sSB913 / File No.
3527 4 of 7 Raised Bill No.913 determination.
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131 determination.
The Commissioner of Social Services, pursuant to section 17b-10, may implement the provisions of this subsection while in the process of adopting regulations, provided the commissioner prints notice of intent to adopt the regulations [in the Connecticut Law LCO No.
The Commissioner of Social Services, pursuant to section 17b-10, may implement the provisions of this subsection while in the process of adopting regulations, provided the commissioner prints notice of intent to adopt the regulations [in the Connecticut Law Journal within] on the Internet web site of the Department of Social sSB913 / File No.
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131 5 sSB913 File No.
913 Journal within] on the Internet web site of the Department of Social Services and the eRegulations System not later than twenty days of adopting such policy.
131 Services and the eRegulations System not later than twenty days of adopting such policy.
(j)To theextent permissibleunder federallaw,anindividual who has applied for Medicaid shall not be determined ineligible on the basis of a single, unliquidated asset, provided such individual presents evidence to the Commissioner of Social Services that such asset is inaccessible to the individual because it is not possible to liquidate the asset in fewer than thirty days.
[(i)] (j) Medical assistance shall be provided, in accordance with the provisions of subsection (e) of section 17a-6, to any child under the supervision of the Commissioner of Children and Families who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for such benefits.
[(i)] (k) Medical assistance shall be provided, in accordance with the provisions of subsection (e) of section 17a-6, to any child under the supervision of the Commissioner of Children and Families who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for such benefits.
Medical assistance shall also be provided to any child in the behavioral services program operated by the Department of Developmental Services who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for benefits.
Medical assistance shall also LCO No.
3527 6 of 7 Raised Bill No.
913 be provided to any child in the behavioral services program operated by the Department of Developmental Services who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for benefits.
[(j)] (l) The Commissioner of Social Services shall provide Early and Periodic Screening, Diagnostic and Treatment program services, as required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal regulations, to all persons who are under the age of twenty-one and otherwise eligible for medical assistance under this section.
[(j)] (k) The Commissioner of Social Services shall provide Early and sSB913 / File No.
[(k)] (m) A veteran, as defined in section 27-103, and any member of his or her family, who applies for or receives assistance under the Medicaid program, shall apply for all benefits for which he or she may be eligible through the United States Department of Veterans Affairs or the United States Department of Defense.
131 6 sSB913 File No.
131 Periodic Screening, Diagnostic and Treatment program services, as required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal regulations, to all persons who are under the age of twenty-one and otherwise eligible for medical assistance under this section.
[(k)] (l) A veteran, as defined in section 27-103, and any member of his or her family, who applies for or receives assistance under the Medicaid program, shall apply for all benefits for which he or she may be eligible through the United States Department of Veterans Affairs or the United States Department of Defense.
3 July 1, 2021 17b-261 Statement of Purpose:
3 July 1, 2021 17b-261 Statement of Legislative Commissioners:
To ensure equity in payment between privately paid and family providers of human services, equity in Medicaid reimbursement for home care services compared to institutional care and fairness to families who discover an asset or are unable to immediately liquidate an asset after applying for Medicaid.
In Section 2, "before applying" was changed to "before applying for Medicaid" for clarity.
[Proposed deletions are enclosed in brackets.
HS Joint Favorable Subst.
Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] LCO No.
sSB913 / File No.
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131 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.
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In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.
Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
OFA Fiscal Note State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $ Social Services, Dept.
GF - Potential See Below See Below Cost Note:
GF=General Fund Municipal Impact:
None Explanation The bill could result in a cost to the Department of Social Services (DSS) associated with making retroactive Medicaid payments for enrollees in the Connecticut Home Care Program for Elders (CHCPE), for up to three months prior to applying for Medicaid.
For context, the average monthly gross cost per enrollee is $2,800.
Making retroactive payments for the three months prior to applying for Medicaid results in a state Medicaid cost of $4,200 per client.
This assumes the approval for such payments by the Centers for Medicare and Medicaid Services (CMS).
The bill makes other changes that could enable certain individuals to achieve Medicaid eligibility sooner to the extent they would otherwise be considered ineligible based solely on the discovery of certain assets.
The actual cost to the state will depend on the number of applicable individuals and the disposition of certain assets.
The Out Years The annualized ongoing fiscal impact identified above would sSB913 / File No.
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131 continue into the future subject to the number of eligible individuals, associated cost of care, and the disposition of certain assets.
Sources:
Department of Social Services Caseload and Utilization Information sSB913 / File No.
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131 OLR Bill Analysis sSB 913 AN ACT REQUIRING FAIRNESS FOR FAMILIES IN MEDICAID ELIGIBILITY AND REIMBURSEMENT DETERMINATIONS.
SUMMARY This bill generally requires, to the extent permissible under federal Medicaid law, (1) payment parity for family caregivers, (2) retroactive coverage for home care services, and (3) a process for resolving undisclosed assets discovered during the application process.
Additionally, the bill replaces an obsolete reference to the Connecticut Law Journal with the Department of Social Services’ (DSS) website and the eRegulations system for posting required notices of intention to adopt regulations.
It also makes technical and conforming changes.
EFFECTIVE DATE:
July 1, 2021 § 1 — FAMILY CAREGIVER PAYMENT RATES The bill requires, to the extent permissible under federal law, payment rates for authorized family caregivers in DSS-administered programs to equal the rates for non-family professional caregivers providing the same types of services to program participants.
By law, the DSS commissioner must determine whether a Medicaid applicant transferred assets in violation of federal law.
Under the bill, the commissioner must use the fair market value of the family caregiver’s provided services when making this determination with regard to a legally enforceable compensation agreement for the services.
§ 2 — RETROACTIVE MEDICAID BENEFITS The bill requires the DSS commissioner to provide, in accordance with federal regulations, retroactive benefits to applicants of the sSB913 / File No.
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131 Connecticut Home Care Program for Elders (CHCPE, see BACKGROUND) for up to three months before the date of their application, as long as they were otherwise eligible during that time period.
In practice and under federal law, DSS already makes retroactive payments for certain other Medicaid services, including long-term care services.
Under federal law, DSS must impose a penalty period when individuals transfer assets for less than fair market value in the 60 months before applying for Medicaid coverage.
The bill makes any CHCPE applicant who has made such a transfer ineligible for the retroactive Medicaid payments and requires the commissioner to impose a penalty period in accordance with federal regulations.
§ 3 — LATE-DISCOVERED ASSETS The bill prohibits, to the extent permissible under federal law, Medicaid coverage denial solely on the basis of an asset discovered by an applicant during the application process, as long as the applicant (1) reports the discovery to DSS within ten days of the discovery and (2) takes steps to liquidate it and spend-down the proceeds in accordance with Medicaid income and asset limits.
The bill directs the department to assist these applicants to gain access to their assets if they are unable to do so.
BACKGROUND Retroactive Medicaid Payments Under federal regulations, individuals are eligible for up to three months of retroactive Medicaid coverage, as long as they (1) received Medicaid services during that time and (2) would have been Medicaid eligible if they had applied (42 C.F.R.
§ 435.915).
Asset Transfer Penalties Generally, the penalty period (in months) is calculated by dividing the value of all assets transferred for less than fair market value during the 60 months before application by the average monthly cost of private nursing home care in the state or community.Medicaid does not pay for sSB913 / File No.
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131 long-term care services and supports during the penalty period.
Connecticut Home Care Program for Elders CHCPE is a Medicaid-waiver and a state-funded program that provides a range of home- and community-based services for eligible individuals age 65 or older who are at risk of inappropriate institutionalization (e.g., nursing home placement).
To be eligible for CHCPE, individuals must meet income and asset limits.
COMMITTEE ACTION Human Services Committee Joint Favorable Substitute Yea 19 Nay 0 (03/09/2021) sSB913 / File No.
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Action History

  1. REF. BY SEN. TO COMM. ON Appropriations

  2. FILE NO. 131

  3. SENATE CALENDAR NUMBER 131

  4. FAV. RPT., TAB. FOR CAL., SEN.

  5. RPTD. OUT OF LCO

  6. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 03/23/21

  7. FILED WITH LCO

  8. Joint Favorable Substitute

  9. PUBLIC HEARING 0223

  10. REF. TO JOINT COMM. ON Human Services

Sponsors

  • David Michel · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 186 not signed on

Sponsors (1)

  • Michel, David

Co-sponsors (0)

None.

Not signed on (186)

186 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Frequently asked questions

Who sponsors SB 913?
SB 913 is sponsored by Michel, David.
What is the current status of SB 913?
This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 913?
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