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H0677aa....................................................by STATE AFFAIRS MEDICALLY INDIGENT - Amends existing law to provide that necessary medical services shall not include any medical service previously provided by the state medical assistance program or regional mental health services which are no longer reimbursed by the Department of Health and Welfare on and after the effective date of this act. 02/25 House intro - 1st rdg - to printing 02/26 Rpt prt - to Health/Wel 02/27 Rpt out - to Gen Ord 02/28 Rpt out amen - to engros 03/01 Rpt engros - 1st rdg - to 2nd rdg as amen 03/04 2nd rdg - to 3rd rdg as amen 03/05 3rd rdg as amen - PASSED - 57-12-1 AYES -- Aikele, Barraclough, Barrett, Bedke, Bell, Black, Block, Bolz, Bradford, Bruneel, Callister, Campbell, Clark, Collins, Crow, Deal, Denney, Ellis, Ellsworth, Eskridge, Field(13), Field(20), Gagner, Gould, Hadley, Hammond, Harwood, Higgins, Hornbeck, Jones, Kellogg(Duncan), Kendell, Kunz, Lake, Langford, Loertscher, Mader, McKague, Meyer, Mortensen, Moyle, Pearce, Pischner, Pomeroy, Raybould, Ridinger, Roberts, Sali, Schaefer, Smith(23), Smylie, Stevenson, Stone, Tilman, Wheeler, Young, Mr. Speaker NAYS -- Bieter, Boe, Cuddy, Henbest, Jaquet, Martinez, Montgomery, Robison, Sellman, Shepherd, Smith(33), Trail Absent and excused -- Wood Floor Sponsor - Loertscher Title apvd - to Senate 03/06 Senate intro - 1st rdg - to Health/Wel
|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-sixth Legislature Second Regular Session - 2002IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 677 BY STATE AFFAIRS COMMITTEE 1 AN ACT 2 RELATING TO THE MEDICALLY INDIGENT; AMENDING SECTION 31-3502, IDAHO CODE, TO 3 PROVIDE THAT NECESSARY MEDICAL SERVICES SHALL NOT INCLUDE ANY MEDICAL SER- 4 VICE PREVIOUSLY PROVIDED BY THE STATE MEDICAL ASSISTANCE PROGRAM OR THE 5 REGIONAL MENTAL HEALTH SERVICES ACT PRIOR TO THE EFFECTIVE DATE OF THIS 6 ACT AND ANY RULES PROMULGATED PURSUANT THERETO; AND DECLARING AN EMER- 7 GENCY. 8 Be It Enacted by the Legislature of the State of Idaho: 9 SECTION 1. That Section 31-3502, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 31-3502. DEFINITIONS. As used in this chapter, the terms defined in this 12 section shall have the following meaning, unless the context clearly indicates 13 another meaning: 14 (1) "Medically indigent" means any person who is in need of necessary 15 medical services and who, if an adult, together with his or her spouse, or 16 whose parents or guardian if a minor, does not have income and other resources 17 available to him from whatever source sufficient to pay for necessary medical 18 services. Nothing in this definition shall prevent the board of county commis- 19 sioners and administrator from requiring the applicant and obligated persons 20 to reimburse the county and the catastrophic health care costs program, where 21 appropriate, for all or a portion of their medical expenses, when investiga- 22 tion of their application pursuant to this chapter, determines their ability 23 to do so. 24 (2) "Hospital" means a facility licensed and regulated pursuant to sec- 25 tions 39-1301 through 39-1314, Idaho Code, excluding state institutions. 26 (3) "Dependent" means any person whom a taxpayer could claim as a depend- 27 ent under the income tax laws of the state of Idaho. 28 (4) "Applicant" means any person who is or may be requesting financial 29 assistance under this chapter. 30 (5) "Reimbursement rates" means the unadjusted medicaid rate of reim- 31 bursement for medical charges allowed pursuant to title XIX of the social 32 security act, as amended. For long-term care facilities, maximum 33 "reimbursement rates" means the unadjusted medicaid rate of reimbursement 34 allowed pursuant to the medical assistance program as determined by chapter 1, 35 title 56, Idaho Code, or the unadjusted medicare rate of reimbursement estab- 36 lished under title XVIII of the social security act, as amended, whichever is 37 greater. 38 (6) "Board" means the board of county commissioners. 39 (7) "Obligated persons" means those persons who are legally responsible 40 for an applicant. 41 (8) "County hospital" means any county approved institution or facility 42 for the care of sick persons. 43 (9) "Administrator" means the board of the catastrophic health care cost 2 1 program, as provided in section 31-3517, Idaho Code. 2 (10) "Catastrophic health care costs" means all necessary medical expenses 3 for services which are incurred by a recipient for which the reimbursement 4 rate exceeds in aggregate the sum of ten thousand dollars ($10,000) in any 5 twelve (12) consecutive month period. 6 (11) "Recipient" means an individual determined eligible for necessary 7 medical services under this chapter. 8 (12) "Resident" means a person with a home, house, place of abode, place 9 of habitation, dwelling or place where he or she actually lived for a consecu- 10 tive period of thirty (30) days or more within the state of Idaho. A resident 11 does not include a person who comes into this state for temporary purposes, 12 including, but not limited to, education, vacation, or seasonal labor. Entry 13 into active military duty shall not change a person's residence for the pur- 14 poses of this chapter. Those physically present within the following facili- 15 ties and institutions shall be residents of the county where they were resi- 16 dents prior to entering the facility or institution: 17 (a) Correctional facilities; 18 (b) Nursing homes or residential or assisted living facilities; 19 (c) Other medical facility or institution. 20 (13) "Emergency service" means a service provided for a medical condition 21 in which sudden, serious and unexpected symptoms of illness or injury are suf- 22 ficiently severe to necessitate or call for immediate medical care. 23 (14) "Provider" means any person, firm, or corporation certified or 24 licensed by the state of Idaho or holding an equivalent license or certifica- 25 tion in another state, that provides necessary medical services as it appears 26 on an application for assistance pursuant to this chapter. 27 (15) "Third party applicant" means a person other than an obligated person 28 who completes, signs and files an application on behalf of a patient. 29 (16) "Clerk" means the clerk of the board or his or her designee. 30 (17) "Resources" means all property, whether tangible or intangible, real 31 or personal, liquid or nonliquid, including, but not limited to, all forms of 32 public assistance, crime victim's compensation, worker's compensation, vet- 33 erans benefits, medicaid, medicare and any other property from any source for 34 which an applicant and/or an obligated person may be eligible or in which he 35 or she may have an interest. Resources shall include the ability of an appli- 36 cant and obligated persons to pay for necessary medical services over a period 37 of up to three (3) years. For purposes of determining approval for medical 38 indigency only, resources shall not include the value of the homestead on the 39 applicant or obligated persons' residence, a burial plot, exemptions for per- 40 sonal property allowed in section 11-605(1) through (3), Idaho Code, and addi- 41 tional exemptions allowed by county resolution. 42 (18) A. "Necessary medical services" means a requested or provided medi- 43 cal service required in order to identify or treat a medically indigent 44 person's health condition, illness or injury and is: 45 (a) Consistent with the symptoms, diagnosis or treatment of the med- 46 ical indigent's condition, illness or injury; 47 (b) In accordance with generally accepted standards of medical or 48 surgical practice then prevailing in the community where the services 49 were provided; 50 (c) Furnished on an outpatient basis whenever it is safe, efficient 51 and reasonable to do so; 52 (d) Not provided primarily for the convenience of the medically 53 indigent person or the provider; 54 (e) The standard, most economical service or item that can safely, 55 reasonably and ethically be provided. 3 1 B. Necessary medical services shall not include the following: 2 (a) Bone marrow transplants; 3 (b) Organ transplants; 4 (c) Elective, cosmetic and/or experimental procedures; 5 (d) Services related to, or provided by, residential and/or shelter 6 care facilities; 7 (e) Normal, uncomplicated pregnancies, excluding caesarean section, 8 and childbirth well-baby care; 9 (f) Medicare copayments and deductibles;and10 (g) Services provided by, or available to an applicant from state, 11 federal and local health programs; and 12 (h) Any medical service previously provided by the state medical 13 assistance program or the regional mental health services act prior 14 to the effective date of this act pursuant to chapter 2, title 56 or 15 chapter 31, title 39, Idaho Code, and any rules promulgated pursuant 16 thereto. 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. An emergency existing therefor, which emergency is hereby 23 declared to exist, this act shall be in full force and effect on and after its 24 passage and approval.
|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-sixth Legislature Second Regular Session - 2002Moved by Loertscher Seconded by Sali IN THE HOUSE OF REPRESENTATIVES HOUSE AMENDMENT TO H.B. NO. 677 1 AMENDMENT TO SECTION 1 2 On page 3 of the printed bill, delete lines 12 through 16 and insert: 3 "(h) Medical services previously provided under state medical assis- 4 tance programs pursuant to chapter 2, title 56, Idaho Code, or mental 5 health services pursuant to chapter 31, title 39, Idaho Code, or any 6 rules promulgated pursuant to either of those chapters, which ser- 7 vices are no longer reimbursed by the department of health and wel- 8 fare on or after the effective date of this paragraph.". 9 CORRECTION TO TITLE 10 On page 1, delete lines 4 through 6 and insert: "VICES PREVIOUSLY PROVIDED 11 UNDER STATE MEDICAL ASSISTANCE PROGRAMS PURSUANT TO CHAPTER 2, TITLE 56, IDAHO 12 CODE, OR MENTAL HEALTH SERVICES PURSUANT TO CHAPTER 31, TITLE 39, IDAHO CODE, 13 OR ANY RULES PROMULGATED PURSUANT TO THOSE TWO CHAPTERS, WHICH SERVICES ARE NO 14 LONGER REIMBURSED BY THE DEPARTMENT OF HEALTH AND WELFARE ON AND AFTER THE 15 EFFECTIVE DATE OF THIS ACT; AND DECLARING AN EMER-".
|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-sixth Legislature Second Regular Session - 2002IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 677, As Amended BY STATE AFFAIRS COMMITTEE 1 AN ACT 2 RELATING TO THE MEDICALLY INDIGENT; AMENDING SECTION 31-3502, IDAHO CODE, TO 3 PROVIDE THAT NECESSARY MEDICAL SERVICES SHALL NOT INCLUDE ANY MEDICAL SER- 4 VICES PREVIOUSLY PROVIDED UNDER STATE MEDICAL ASSISTANCE PROGRAMS PURSUANT 5 TO CHAPTER 2, TITLE 56, IDAHO CODE, OR MENTAL HEALTH SERVICES PURSUANT TO 6 CHAPTER 31, TITLE 39, IDAHO CODE, OR ANY RULES PROMULGATED PURSUANT TO 7 THOSE TWO CHAPTERS, WHICH SERVICES ARE NO LONGER REIMBURSED BY THE DEPART- 8 MENT OF HEALTH AND WELFARE ON AND AFTER THE EFFECTIVE DATE OF THIS ACT; 9 AND DECLARING AN EMERGENCY. 10 Be It Enacted by the Legislature of the State of Idaho: 11 SECTION 1. That Section 31-3502, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 31-3502. DEFINITIONS. As used in this chapter, the terms defined in this 14 section shall have the following meaning, unless the context clearly indicates 15 another meaning: 16 (1) "Medically indigent" means any person who is in need of necessary 17 medical services and who, if an adult, together with his or her spouse, or 18 whose parents or guardian if a minor, does not have income and other resources 19 available to him from whatever source sufficient to pay for necessary medical 20 services. Nothing in this definition shall prevent the board of county commis- 21 sioners and administrator from requiring the applicant and obligated persons 22 to reimburse the county and the catastrophic health care costs program, where 23 appropriate, for all or a portion of their medical expenses, when investiga- 24 tion of their application pursuant to this chapter, determines their ability 25 to do so. 26 (2) "Hospital" means a facility licensed and regulated pursuant to sec- 27 tions 39-1301 through 39-1314, Idaho Code, excluding state institutions. 28 (3) "Dependent" means any person whom a taxpayer could claim as a depend- 29 ent under the income tax laws of the state of Idaho. 30 (4) "Applicant" means any person who is or may be requesting financial 31 assistance under this chapter. 32 (5) "Reimbursement rates" means the unadjusted medicaid rate of reim- 33 bursement for medical charges allowed pursuant to title XIX of the social 34 security act, as amended. For long-term care facilities, maximum 35 "reimbursement rates" means the unadjusted medicaid rate of reimbursement 36 allowed pursuant to the medical assistance program as determined by chapter 1, 37 title 56, Idaho Code, or the unadjusted medicare rate of reimbursement estab- 38 lished under title XVIII of the social security act, as amended, whichever is 39 greater. 40 (6) "Board" means the board of county commissioners. 41 (7) "Obligated persons" means those persons who are legally responsible 42 for an applicant. 43 (8) "County hospital" means any county approved institution or facility 2 1 for the care of sick persons. 2 (9) "Administrator" means the board of the catastrophic health care cost 3 program, as provided in section 31-3517, Idaho Code. 4 (10) "Catastrophic health care costs" means all necessary medical expenses 5 for services which are incurred by a recipient for which the reimbursement 6 rate exceeds in aggregate the sum of ten thousand dollars ($10,000) in any 7 twelve (12) consecutive month period. 8 (11) "Recipient" means an individual determined eligible for necessary 9 medical services under this chapter. 10 (12) "Resident" means a person with a home, house, place of abode, place 11 of habitation, dwelling or place where he or she actually lived for a consecu- 12 tive period of thirty (30) days or more within the state of Idaho. A resident 13 does not include a person who comes into this state for temporary purposes, 14 including, but not limited to, education, vacation, or seasonal labor. Entry 15 into active military duty shall not change a person's residence for the pur- 16 poses of this chapter. Those physically present within the following facili- 17 ties and institutions shall be residents of the county where they were resi- 18 dents prior to entering the facility or institution: 19 (a) Correctional facilities; 20 (b) Nursing homes or residential or assisted living facilities; 21 (c) Other medical facility or institution. 22 (13) "Emergency service" means a service provided for a medical condition 23 in which sudden, serious and unexpected symptoms of illness or injury are suf- 24 ficiently severe to necessitate or call for immediate medical care. 25 (14) "Provider" means any person, firm, or corporation certified or 26 licensed by the state of Idaho or holding an equivalent license or certifica- 27 tion in another state, that provides necessary medical services as it appears 28 on an application for assistance pursuant to this chapter. 29 (15) "Third party applicant" means a person other than an obligated person 30 who completes, signs and files an application on behalf of a patient. 31 (16) "Clerk" means the clerk of the board or his or her designee. 32 (17) "Resources" means all property, whether tangible or intangible, real 33 or personal, liquid or nonliquid, including, but not limited to, all forms of 34 public assistance, crime victim's compensation, worker's compensation, vet- 35 erans benefits, medicaid, medicare and any other property from any source for 36 which an applicant and/or an obligated person may be eligible or in which he 37 or she may have an interest. Resources shall include the ability of an appli- 38 cant and obligated persons to pay for necessary medical services over a period 39 of up to three (3) years. For purposes of determining approval for medical 40 indigency only, resources shall not include the value of the homestead on the 41 applicant or obligated persons' residence, a burial plot, exemptions for per- 42 sonal property allowed in section 11-605(1) through (3), Idaho Code, and addi- 43 tional exemptions allowed by county resolution. 44 (18) A. "Necessary medical services" means a requested or provided medi- 45 cal service required in order to identify or treat a medically indigent 46 person's health condition, illness or injury and is: 47 (a) Consistent with the symptoms, diagnosis or treatment of the med- 48 ical indigent's condition, illness or injury; 49 (b) In accordance with generally accepted standards of medical or 50 surgical practice then prevailing in the community where the services 51 were provided; 52 (c) Furnished on an outpatient basis whenever it is safe, efficient 53 and reasonable to do so; 54 (d) Not provided primarily for the convenience of the medically 55 indigent person or the provider; 3 1 (e) The standard, most economical service or item that can safely, 2 reasonably and ethically be provided. 3 B. Necessary medical services shall not include the following: 4 (a) Bone marrow transplants; 5 (b) Organ transplants; 6 (c) Elective, cosmetic and/or experimental procedures; 7 (d) Services related to, or provided by, residential and/or shelter 8 care facilities; 9 (e) Normal, uncomplicated pregnancies, excluding caesarean section, 10 and childbirth well-baby care; 11 (f) Medicare copayments and deductibles;and12 (g) Services provided by, or available to an applicant from state, 13 federal and local health programs; and 14 (h) Medical services previously provided under state medical assis- 15 tance programs pursuant to chapter 2, title 56, Idaho Code, or mental 16 health services pursuant to chapter 31, title 39, Idaho Code, or any 17 rules promulgated pursuant to either of those chapters, which ser- 18 vices are no longer reimbursed by the department of health and wel- 19 fare on or after the effective date of this paragraph. 20 Provided however, each board may determine, by ordinance or resolution 21 duly adopted in its county, to include as necessary medical services addi- 22 tional services not covered in this section. Necessary medical services pro- 23 vided by this option shall not be paid by the catastrophic health care costs 24 program, and shall remain the liability of the respective county. 25 SECTION 2. An emergency existing therefor, which emergency is hereby 26 declared to exist, this act shall be in full force and effect on and after its 27 passage and approval.
STATEMENT OF PURPOSE RS l2l37Cl This legislation clarifies that should reductions in Medicaid occur that Counties would not have an unfunded mandate to provide those services. FISCAL IMPACT No fiscal impact. Contact Name: Rep. Tom Loertscher Phone: (208) 332-1000 STATEMENT OF PURPOSE/FISCAL NOTE H 677