AB 374 — Requires the Department of Health and Human Services, if authorized by federal law, to establish a health care plan within Medicaid for purchase by persons who are not otherwise eligible for Medicaid. (BDR 38-881)

(ReprintedAssembly withBill amendmentsNo. adopted on May 19, 2017) FIRST REPRINT A.B.

374374–Assemblymen ASprinkle, SSEMBLYFrierson, BILLAraujo, NCarlton, O.Cohen;

374–ASSEMBLYMENElliot SAnderson, PRINKLE,Benitez-Thompson, FRIERSON,Bilbray-Axelrod, ABrooks, RAUJO,Bustamante CARLTONAdams, ,Carrillo, COHEN;Daly, Diaz, Flores, Fumo, Jauregui, Joiner, McCurdy II, Miller, Neal, Ohrenschall, Spiegel, Swank, Thompson, Watkins and Yeager CHAPTER..........

ELLIOT ANDERSON , BENITEZ- THOMPSON , BILBRAY -AXELROD , BROOKS , BUSTAMANTE A DAMS , C ARRILLO , D ALY, D IAZ, FLORES, FUMO , JAUREGUI , OINER , M CCURDY II, M ILLER, N EAL, O HRENSCHALL , SPIEGEL, SWANK , THOMPSON , W ATKINS AND Y EAGER M ARCH 20, 2017 ____________ Referred to Committee on Health and Human Services SUMMARY—Requires the Department of Health and Human Services, if authorized by federal law, to establish a health care plan within Medicaid for purchase by persons who are not otherwise eligible for Medicaid.

(BDR 38-881) FISCAL NOTE:

Effect on Local Government:

No.

Effect on the State:

Yes.

~ EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

The Patient Protection and Affordable Care Act (Public Law 111-148, as amended) provides a refundable federal income tax credit and cost-sharing reductions to certain eligible persons who earn not more than 400 percent of the federally designated poverty level in order to offset the cost of certain health care plan premiums.

§ 155.305) ThealthThe care - *AB374_R1* – 2 – Act further requires that such credits and cost-sharing reductions only be made available to purchase health insurance which is offered on a state health insurance exchange, which includes, without limitation, the Silver State Health Insurance Exchange established by this State in 2011.

§§ 1315, 18052) Existingpromote federalaccess law states that the purpose of the Medicaid program is to 1396) Existing law authorizes this State to enroll Medicaid recipients in a managed care program provided by a health maintenanceinsurance organizationfor pursuantcertain tolow-income apersons. contract with the Nevada Department of Health and Human Services.

§ 1396) Existing law authorizes this State to enroll Medicaid recipients in a managed care program provided by a health maintenance organization pursuant to a contract with the Nevada Department of Health and Human Services.

(42 U.S.C.

NRS 422.273) Existing federal law also authorizes a state to receive its Federal Medical Assistance Percentage (FMAP) allotment of money from the Federal Government to reimburse providers of health care for medical services which are provided as part of a managed care program.

§§ 1396d, 1396u-2)1396u-2)ch are Existing law requires this State to develop a State Plan for Medicaid which includes, without limitation, a list of the medical services provided to Medicaid fromrecipients. using FMAP or other federal Medicaid money to reimburse a provider of state health care for medical services which are provided to a person who earns more than 138 percent of the federally designated poverty level or for other expenses which are unrelated to the administration of Medicaid.

§ 1396a;

NRS 422.063) Existing law also prohibits a state from using FMAP or other federal Medicaid money to reimburse a provider of health care for medical services which are provided to a person who earns more than 138 percent of the federally designated poverty level or for other expenses - 79th Session (2017) – 2 – which are unrelated to the administration of Medicaid.

(42 U.S.C.

433.15(b)) Section 2 of this bill requires the Director of the Nevada Department of Health and Human Services to seek any necessary waiver of certain provisions of federal law to allow the Nevada Care Plan, if established pursuant to section 3 of this bill, to be offered by certain insurers or for purchase through the Silver State HealthHealthill, Additionally,Insurance sectionExchange 2 requires the Director to seek any necessary federal waiver to allow persons towho useare theotherwise federalineligible incomefor taxMedicaid. credits and cost-sharing reductions authorized by the Act to purchase coverage through the Nevada Care Plan.

SectionAdditionally, 5section of2 thisrequires billthe revisesDirector theto definitionseek ofany “qualifiednecessary healthfederal plan”waiver to includeallow thepersons Nevadato Careuse Planthe sofederal thatincome ittax maycredits beand offeredcost-sharing forreductions purchaseauthorized inby the sameAct mannerto aspurchase othercoverage health plans through the SilverNevada StateCare HealthPlan. Insurance Exchange, if established.

Section 3 of this bill requires the Department, to the extent allowed by federal law, to establish the Nevada Care Plan withinso Medicaidthat andit makemay coveragebe throughoffered the Plan available for purchase toin any person who is not otherwise eligible for to be the same manner as thoseother providedhealthada toplans Medicaidthrough recipients who do not participate in the MedicaidSilver managedState careHealth program,Insurance exceptExchange, thatif transportationestablished. services that are provided when there is not an emergency are not required to be covered.

Section 3 of this bill requires the Department, to the extent allowed by federal law, to establish the Nevada Care Plan within Medicaid and make coverage through the Plan available for purchase to any person who is not otherwise eligible for Medicaid.

Section 3 further requires the benefits offered by the Nevada Care Plan the Medicaid managed care program, except that transportation services that arein provided when there is not an emergency are not required to be covered.

-EXPLANATION *AB374_R1* – 3Matter –in THEbolded PEOPLEitalics OFis THEnew; STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Sectionmatter 1.between brackets [omitted material] is material to be omitted.

THE PSENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

IN Section 1.

To the extent allowed by federal law, the Director shall establish the Nevada Care Plan within Medicaid and make - 79th Session (2017) – 3 – coverage available for purchase through the Plan to any person who is not otherwise eligible for Medicaid.

The coverage provided to a person who enrolls in the Nevada Care Plan must be the same as the coverage provided to recipients of Medicaid who do not participate in a Medicaid managed care program, except that transportation services that are provided when there is not an emergency, including, without limitation, pursuant to NRS 422.27495, are not required to be included in such coverage.

- *AB374_R1* – 4 – Sec.

1.the Federal Act [.] ;

Aorch health plan which meets the requirements of § 1301 of the2. Federal Act [.] ;

or 2.

Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity - 79th Session (2017) – 4 – to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of appropriated money remaining must not be spent for any purpose after September 21, 2018, and September 20, 2019, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 21, 2018, and September 20, 2019, respectively.

becomeSec. effective upon passage and approval.and 2 of this act 2.

6.

1.