2000 Legislation
Print Friendly

HOUSE BILL NO. 573 – Medical assistance/county/residency


View Daily Data Tracking History

View Bill Text

View Statement of Purpose / Fiscal Impact

Text to be added within a bill has been marked with Bold and
Underline. Text to be removed has been marked with
Strikethrough and Italic. How these codes are actually displayed will
vary based on the browser software you are using.

This sentence is marked with bold and underline to show added text.

This sentence is marked with strikethrough and italic, indicating
text to be removed.

Daily Data Tracking History

H0573.................................................by HEALTH AND WELFARE
MEDICAL ASSISTANCE - Amends existing law relating to medical indigency to
impose a state residency requirement of thirty days; to clarify
requirements for approval of a uniform application for county medical
assistance; and to require medical providers to reimburse a county when
payments are received from other resources.
02/15    House intro - 1st rdg - to printing
02/16    Rpt prt - to Health/Wel
02/23    Rpt out - rec d/p - to 2nd rdg
02/24    2nd rdg - to 3rd rdg
02/25    3rd rdg - PASSED - 56-0-14
      AYES -- Barraclough, Barrett, Bell, Bieter, Black, Boe, Bruneel,
      Cheirrett, Clark, Crow, Cuddy, Deal, Denney, Ellsworth, Field(13),
      Field(20), Gagner, Geddes, Hadley, Hammond, Hansen(23), Henbest,
      Hornbeck, Jaquet, Judd, Kempton, Kendell, Kunz, Lake, Linford,
      Loertscher, Mader, Marley, McKague, Meyer, Montgomery, Mortensen,
      Moss, Moyle, Pearce, Pomeroy, Reynolds, Ridinger, Ringo, Robison,
      Sali, Schaefer, Sellman, Shepherd, Smylie, Stoicheff, Stone, Tilman,
      Wheeler, Wood, Zimmermann
      NAYS -- None
      Absent and excused -- Alltus, Callister, Campbell, Chase, Gould,
      Hansen(29), Jones, Kellogg, Pischner, Smith, Stevenson, Taylor,
      Trail(Miller), Mr Speaker
    Floor Sponsor - Reynolds
    Title apvd - to Senate
02/28    Senate intro - 1st rdg - to Health/Wel
03/10    Rpt out - rec d/p - to 2nd rdg
03/13    2nd rdg - to 3rd rdg
03/29    3rd rdg - PASSED - 32-0-3
      AYES--Boatright, Branch, Bunderson, Burtenshaw, Cameron, Crow,
      Danielson, Darrington, Davis, Deide, Frasure, Geddes, Hawkins,
      Ingram, Ipsen, Keough, King-Barrutia, Lee, McLaughlin, Noh, Parry,
      Richardson, Riggs, Risch, Sandy, Schroeder, Sorensen, Stegner,
      Thorne, Wheeler, Whitworth, Williams
      Absent and excused--Andreason, Dunklin, Stennett
    Floor Sponsor - King-Barrutia
    Title apvd - to House
03/30    To enrol
03/31    Rpt enrol - Sp signed
04/03    Pres signed - to Governor
04/14    Governor signed
         Session Law Chapter 317
         Effective: 07/01/00

Bill Text

  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-fifth Legislature                  Second Regular Session - 2000
                              IN THE HOUSE OF REPRESENTATIVES
                                     HOUSE BILL NO. 573
                              BY HEALTH AND WELFARE COMMITTEE
  1                                        AN ACT
 13    Be It Enacted by the Legislature of the State of Idaho:
 14        SECTION  1.  That  Section 31-3502, Idaho Code, be, and the same is hereby
 15    amended to read as follows:
 16        31-3502.  DEFINITIONS. As used in this chapter, the terms defined in  this
 17    section shall have the following meaning, unless the context clearly indicates
 18    another meaning:
 19        (1)  "Medically  indigent"  means  any  person who is in need of necessary
 20    medical services and who, if an adult, together with his  or  her  spouse,  or
 21    whose parents or guardian if a minor, does not have income and other resources
 22    available  to him from whatever source sufficient to pay for necessary medical
 23    services. Nothing in this definition shall prevent the board of county commis-
 24    sioners and administrator from requiring the applicant and  obligated  persons
 25    to  reimburse the county and the catastrophic health care costs program, where
 26    appropriate, for all or a portion of their medical expenses,  when  investiga-
 27    tion  of  their application pursuant to this chapter, determines their ability
 28    to do so.
 29        (2)  "Hospital" means a facility licensed and regulated pursuant  to  sec-
 30    tions 39-1301 through 39-1314, Idaho Code, excluding state institutions.
 31        (3)  "Dependent" means any person whom a taxpayer could claim as a depend-
 32    ent under the income tax laws of the state of Idaho.
 33        (4)  "Applicant"  means  any  person who is or may be requesting financial
 34    assistance under this chapter.
 35        (5)  "Reimbursement rates" means the unadjusted  medicaid  rate  of  reim-
 36    bursement  for  medical  charges  allowed  pursuant to title XIX of the social
 37    security  act,  as   amended.   For   long-term   care   facilities,   maximum
 38    "reimbursement  rates"  means  the  unadjusted  medicaid rate of reimbursement
 39    allowed pursuant to the medical assistance program as determined by chapter 1,
 40    title 56, Idaho Code, or the unadjusted medicare rate of reimbursement  estab-
 41    lished  under title XVIII of the social security act, as amended, whichever is
 42    greater.
 43        (6)  "Board" means the board of county commissioners.
  1        (7)  "Obligated persons" means those persons who are  legally  responsible
  2    for an applicant.
  3        (8)  "County  hospital"  means any county approved institution or facility
  4    for the care of sick persons.
  5        (9)  "Administrator" means the board of the catastrophic health care  cost
  6    program, as provided in section 31-3517, Idaho Code.
  7        (10) "Catastrophic health care costs" means all necessary medical expenses
  8    for  services  which  are  incurred by a recipient for which the reimbursement
  9    rate exceeds in aggregate the sum of ten thousand  dollars  ($10,000)  in  any
 10    twelve (12) consecutive month period.
 11        (11) "Recipient"  means  an  individual  determined eligible for necessary
 12    medical services under this chapter.
 13        (12) "Resident" means a person with a home, house, place of  abode,  place
 14    of habitation, dwelling or place where he or she actually lived for a consecu-
 15    tive  period of thirty (30) days or more within the state of Idaho. A resident
 16    does not include a person who comes into this state  for  temporary  purposes,
 17    including,  but  not limited to, education, vacation, or seasonal labor. Entry
 18    into active military duty shall not change a person's residence for  the  pur-
 19    poses  of  this chapter. Those physically present within the following facili-
 20    ties and institutions shall be residents of the county where they  were  resi-
 21    dents prior to entering the facility or institution:
 22        (a)  Correctional facilities;
 23        (b)  Nursing homes or residential care facilities;
 24        (c)  Other medical facility or institution.
 25        (13) "Emergency  service" means a service provided for a medical condition
 26    in which sudden, serious and unexpected symptoms of illness or injury are suf-
 27    ficiently severe to necessitate or call for immediate medical care.
 28        (14) "Provider" means  any  person,  firm,  or  corporation  certified  or
 29    licensed  by the state of Idaho or holding an equivalent license or certifica-
 30    tion in another state, that provides necessary medical services as it  appears
 31    on an application for assistance pursuant to this chapter.
 32        (15) "Third party applicant" means a person other than an obligated person
 33    who completes, signs and files an application on behalf of a patient.
 34        (16) "Clerk" means the clerk of the board or his or her designee.
 35        (17) "Resources"  means all property, whether tangible or intangible, real
 36    or personal, liquid or nonliquid, including, but not limited to, all forms  of
 37    public  assistance,  crime  victim's compensation, worker's compensation, vet-
 38    erans benefits, medicaid, medicare and any other property from any source  for
 39    which  an  applicant and/or an obligated person may be eligible or in which he
 40    or she may have an interest. Resources shall include the ability of an  appli-
 41    cant and obligated persons to pay for necessary medical services over a period
 42    of  up  to  three  (3) years. For purposes of determining approval for medical
 43    indigency only, resources shall not include the value of the homestead on  the
 44    applicant  or obligated persons' residence, a burial plot, exemptions for per-
 45    sonal property allowed in section 11-605(1) through (3), Idaho Code, and addi-
 46    tional exemptions allowed by county resolution.
 47        (18) A.  "Necessary medical services" means a requested or provided  medi-
 48        cal  service  required  in order to identify or treat a medically indigent
 49        person's health condition, illness or injury and is:
 50             (a)  Consistent with the symptoms, diagnosis or treatment of the med-
 51             ical indigent's condition, illness or injury;
 52             (b)  In accordance with generally accepted standards  of  medical  or
 53             surgical practice then prevailing in the community where the services
 54             were provided;
 55             (c)  Furnished  on an outpatient basis whenever it is safe, efficient
  1             and reasonable to do so;
  2             (d)  Not provided primarily for  the  convenience  of  the  medically
  3             indigent person or the provider;
  4             (e)  The  standard,  most economical service or item that can safely,
  5             reasonably and ethically be provided.
  6        B.  Necessary medical services shall not include the following:
  7             (a)  Bone marrow transplants;
  8             (b)  Organ transplants;
  9             (c)  Elective, cosmetic and/or experimental procedures;
 10             (d)  Services related to, or provided by, residential and/or  shelter
 11             care facilities;
 12             (e)  Normal,  uncomplicated pregnancies, excluding caesarean section,
 13             and childbirth well-baby care;
 14             (f)  Medicare copayments and deductibles; and
 15             (g)  Services provided by, or available to an applicant  from  state,
 16             federal and local health programs.
 17        Provided  however,  each  board  may determine, by ordinance or resolution
 18    duly adopted in its county, to include as  necessary  medical  services  addi-
 19    tional  services  not covered in this section. Necessary medical services pro-
 20    vided by this option shall not be paid by the catastrophic health  care  costs
 21    program, and shall remain the liability of the respective county.
 22        SECTION  2.  That  Section 31-3504, Idaho Code, be, and the same is hereby
 23    amended to read as follows:
 24        31-3504.  APPLICATION FOR FINANCIAL ASSISTANCE. (1) An applicant  request-
 25    ing  assistance  under this chapter from the state or any county in this state
 26    shall complete a written application on a uniform form agreed to by the  Idaho
 27    association  of counties and the Idaho hospital association. prior to June 30,
 28    1996. The truth of the matters contained in the application shall be sworn  to
 29    by  the  applicant. The application shall be signed by the applicant or on the
 30    applicant's behalf and filed in the clerk's office.
 31        (2)  If a third party application is filed, the application  shall  be  as
 32    complete  as  practical and presented in the same form and manner as set forth
 33    above.
 34        (3)  Follow-up necessary medical services based on a treatment  plan,  for
 35    the same condition, preapproved by the board, may be provided for a maximum of
 36    six  (6) months from the date of the original application without requiring an
 37    additional application; however, a request for additional treatment not speci-
 38    fied in the approved treatment plan shall be filed with  the  clerk  ten  (10)
 39    days  prior  to  receiving  services.  Beyond the six (6) months, requests for
 40    additional treatment related to an original diagnosis  in  accordance  with  a
 41    preapproved  treatment  plan  shall  be filed ten (10) days prior to receiving
 42    services and an updated application may be requested by the board.
 43        (4)  Upon application for financial assistance pursuant to this chapter an
 44    automatic lien shall attach to all real and personal property of the applicant
 45    and on insurance benefits to which the applicant may become entitled. The lien
 46    shall also attach to any additional resources to which it may  legally  attach
 47    not  covered above. The lien created by this section may be, in the discretion
 48    of the board, perfected as to real property and fixtures by recording, in  any
 49    county  recorder's  office  in this state in which the applicant and obligated
 50    party own property a notice of application for medical indigency benefits on a
 51    uniform form agreed to by the Idaho association of counties and the Idaho hos-
 52    pital association, prior to June 30, 1996, which form  shall  be  recorded  as
 53    provided  herein  within  thirty (30) days from receipt of an application, and
  1    such lien, if so recorded, shall have a priority date as of the date the  nec-
  2    essary  medical  services  were provided. The lien created by this section may
  3    also be, in the discretion of the board,  perfected as to personal property by
  4    filing with the secretary of state within thirty (30) days of  receipt  of  an
  5    application,  a  notice  of  application in substantially the same manner as a
  6    filing under chapter 9, title 28, Idaho Code, except that such notice need not
  7    be signed and no fee shall be required, and, if so filed, such lien shall have
  8    the priority date as of the date the necessary medical services were provided.
  9    An application for assistance pursuant to this chapter shall waive any  confi-
 10    dentiality  granted  by  state  law  to  the extent necessary to carry out the
 11    intent of this section.
 12        SECTION 3.  That Section 31-3505, Idaho Code, be, and the same  is  hereby
 13    amended to read as follows:
 15    Applications and requests for necessary medical services shall be  filed  with
 16    the  clerk  according  to  the  following time limits. Filing is complete upon
 17    receipt by the clerk.
 18        (1)  An application for nonemergency necessary medical services  shall  be
 19    filed ten (10) days prior to receiving services from the provider.
 20        (2)  An application for emergency necessary medical services shall be made
 21    any  time  within thirty-one (301) days following beginning with the first day
 22    of the provision of necessary medical services from the  provider  or  in  the
 23    case of hospitalization, thirty-one (301) days from beginning with the date of
 24    admission.
 25        (3)  Requests for additional treatment related to an original diagnosis in
 26    accordance  with  a  preapproved  treatment  plan shall be filed ten (10) days
 27    prior to receiving services.
 28        (4)  (a) A delayed application for necessary medical services may be filed
 29        up to one hundred eighty (180) days after beginning with the first day  of
 30        the provision of necessary medical services on condition that the provider
 31        and/or  applicant  demonstrates  that  an  application or claim for social
 32        security, third party insurance, medicaid, medicare, crime victims compen-
 33        sation, and/or worker's compensation was timely filed within  ninety  (90)
 34        days  following beginning with the first day of the provision of necessary
 35        medical services from the provider or, in  the  case  of  hospitalization,
 36        ninety (90) days from beginning with the date of admission.
 37        (b)  In  the event that a county determines that a different county is the
 38        obligated county, an application may be filed within thirty (30)  days  in
 39        the other county within thirty (30) days of the date of the initial county
 40        denial.
 41        SECTION  4.  That  Section 31-3506, Idaho Code, be, and the same is hereby
 42    amended to read as follows:
 43        31-3506.  OBLIGATED COUNTY. The county  obligated  for  payment  shall  be
 44    determined as follows:
 45        (1)  The   obligated   county   for   payment   of   pharmaceuticals   for
 46    noninstitutionalized  individuals shall be the county where the applicant cur-
 47    rently resides.
 48        (2)  The obligated county for payment of necessary  medical  services  for
 49    medical indigent individuals shall be as follows:
 50        (a)  The last county in which the applicant or head of household has main-
 51        tained  a  residence  for  six (6) consecutive months or longer within the
  1        past five (5) years preceding  application  shall  be  obligated.  If  the
  2        applicant or head of household maintains  another residence in a different
  3        county  or  state  for purposes of employment, the county where the family
  4        residence is maintained  shall  be  deemed  the  applicant's  or  head  of
  5        household's place of residence.
  6        (b)  If  an  individual  has not resided in any county for a period of six
  7        (6) months within the five (5) years preceding incurrence of medical costs
  8        for which counties have a responsibility in whole or  in  part,  then  the
  9        county where the applicant maintained a residence for at least thirty (30)
 10        days immediately preceding such incurrence shall be the obligated county.
 11        (c)  Active  military  duty, or being admitted as a patient in a hospital,
 12        nursing home, other medical facility or institution, shall not change  the
 13        obligated  county.  The county obligated shall remain the same county that
 14        would  have  been  obligated  prior  to  institutionalization   as   above
 15        described.
 16        (d)  For full-time students at public institutions of higher learning, the
 17        obligated  county shall be the county of residence of the applicant unless
 18        an obligated person, for whom the applicant is  claimed  as  a  dependent,
 19        resides in another county or state.
 20        (e)  If  an  individual  has  not  resided in any county for a consecutive
 21        period of thirty (30) days but has resided in the state  of  Idaho  for  a
 22        consecutive  period of thirty (30) days then the county where the individ-
 23        ual last resided prior to receiving medical services shall  be  the  obli-
 24        gated county.
 25        SECTION  5.  That  Section 31-3509, Idaho Code, be, and the same is hereby
 26    amended to read as follows:
 27        31-3509.  COLLECTIONS BY PROVIDERS. Providers making claims for  necessary
 28    medical  services  of  medically  indigent  persons  shall make all reasonable
 29    efforts to determine liability for the account so incurred from any  available
 30    insurance  or  other  sources  available for payment of such expenses prior to
 31    submitting the bill to the county for payment. In the event  that  a  provider
 32    has  been notified that an individual qualifies for approval of benefits, such
 33    provider(s) shall submit a bill to third party insurance, medicaid,  medicare,
 34    crime  victims  compensation  and/or  worker's compensation for payment within
 35    thirty (30) days of such notice. In the  event  any  payments  are  thereafter
 36    received for charges which have been paid by a county and/or the administrator
 37    pursuant  to  the provisions of this chapter, said sums up to the amount actu-
 38    ally paid by the county and/or the administrator shall be paid  over  to  such
 39    county  and/or  administrator within sixty (60) days of receiving such payment
 40    from other resources.

Statement of Purpose / Fiscal Impact

                 STATEMENT OF PURPOSE
                       RS 09853 
     The purpose of this bill is to provide some technical changes in the medical
     indigency statutes to clarify the following: 
     1.   That a person must be a resident of the state of Idaho for 30 days, not a
     particular county to qualify for benefits. 
     2.   That the Idaho Association of Counties and Idaho Hospital Association must
     approve a uniform application for county medical assistance. 
     3.   That the process for filing an application for county medical indigent
     assistance begins with the first day of the provision of necessary medical services. 
     4.   That medical providers submit a bill to another resource within 30 days of
     being notified and then reimburse such county within 60 days of receiving a
     payment from such other resource. 
                    FISCAL IMPACT 
     There is no fiscal impact on the state general fund. There is no impact on any
     political subdivision or medical provider in this state. 
               CONTACT:  Marcia Wingfield, Shoshone County Clerk 752-1264 
               Tony Poinelli, Idaho Association of Counties 345-9126 
                                             STATEMENT OF PURPOSE/FISCAL IMPACT                           H 573