H. B. 2884
(By Delegates Campbell, Border, Perdue,
Webster and White)
[Introduced March 2, 2009; referred to the
Committee on Senior Citizen Issues then Finance.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §9-4E-1, §9-4E-2 and
§9-4E-3, all relating to Medicaid; the development of a
public-private long-term care partnership program.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new article, designated §9-4E-1, §9-4E-2 and
§9-4E-3, all to read as follows:
ARTICLE 4E. Long-Term Care Partnership Program.
§9-4E-1. Purpose.
(a) The purpose of this program shall be to reduce Medicaid
costs for long-term care by encouraging the purchase of private
long-term care insurance policies that are covered under the
"qualified state long-term care insurance partnerships."
(b) It is the intent of the long-term care partnership to do all of the following:
(1) Provide incentives for individuals to insure against the
costs of providing for their long-term care needs.
(2) Provide a mechanism for individuals to qualify for
coverage of the cost of their long-term care needs under Medicaid
without first being required to substantially exhaust their
resources.
(3) Alleviate the financial burden on the state's medical
assistance program by encouraging the pursuit of private
initiatives.
§9-4E-2. Definitions.
(a) "Asset disregard" means, with regard to the state's
medical assistance program, disregarding any assets or resources in
an amount equal to the insurance benefit payments that are made to
or on behalf of an individual who is a beneficiary under a
qualified long-term care insurance partnership policy.
(b) "Long-term care insurance" means a policy described in
section four (a), article fifteen (A), chapter thirty-three of this
code.
(c) "Long-term care partnership program" means a qualified
state long-term care insurance partnership as defined in 42 U.S.C.
1396, Section 1917(b) of the Social Security Act.
(d) "Medicaid" means that assistance provided under a state
plan implemented by subchapter nineteen, chapter seven, Title 42, United States Code, as that chapter has been and may hereafter be
amended.
§9-4E-3. Authority.
(a) The program shall be administered by the Bureau for
Medical Services in collaboration with the Insurance Commission.
They shall establish a long-term care partnership program in West
Virginia in order to provide for the financing of long-term care
through a combination of private insurance and Medicaid in
accordance with federal requirements on qualified state long-term
care insurance partnerships.
(b) Not later than ninety days after the effective date of
this article, the Bureau for Medical Services shall file a state
plan amendment, pursuant to Title XIX of the United States Social
Security Act and any amendments thereto, to the United States
Department of Health and Human Services to establish that the
assets an individual owns and may retain under Medicaid and still
qualify for benefits under Medicaid at the time the individuals
applies for benefits is increased dollar-for-dollar for each dollar
paid out under the individuals's long-term care insurance policy if
the individual is a beneficiary of a qualified long-term care
partnership program policy.
(c) An individual who is a beneficiary of a West Virginia
long-term care partnership program and meets eligibility
requirements is eligible for assistance under the state's medical assistance program using the asset disregard as provided under
subsection (b).
(d) The Bureau of Medical Services shall pursue reciprocal
agreements with other states to extend the asset disregard to West
Virginia residents who purchased long-term care partnership
policies in other states that are compliant with Title VI, Section
6021 of the Federal Deficit Reduction Act of 2005, PL 109-171, and
any applicable federal regulations or guidelines.
(e) Upon diminishment of assets below the anticipated
remaining benefits under a long-term care partnership program
policy, certain assets of an individual, as provided under
subsection (b), shall not be considered when determining any of the
following:
(1) Medicaid eligibility;
(2) The amount of any Medicaid payment;
(3) Any subsequent recovery by the state of a payment for
medical services or long-term care services.
(f) If the long-term care partnership program is discontinued,
an individual who purchased a West Virginia long-term care
partnership program policy before the date the program was
discontinued shall be eligible to receive asset disregard if
allowed as provided by Title VI, Section 6021 of the Federal
Deficit Reduction Act of 2005, PL 109-171.
NOTE: The purpose of this bill is to establish a public-
private state long-term care partnership program.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
THIS BILL IS AN INTERIM BILL RECOMMENDED FOR PASSAGE BY THE
SELECT COMMITTEE PEIA, SENIORS AND LONG TERM CARE.