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S1484................................................by JUDICIARY AND RULES
MEDICAID - Amends existing law to govern the calculations of Medicaid
reimbursements when Medicare coverage is provided due to a temporary change
in a patient's condition.
02/28 Senate intro - 1st rdg - to printing
03/01 Rpt prt - to Health/Wel
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-sixth Legislature Second Regular Session - 2002
IN THE SENATE
SENATE BILL NO. 1484
BY JUDICIARY AND RULES COMMITTEE
1 AN ACT
2 RELATING TO CALCULATIONS OF MEDICAID; AMENDING CHAPTER 2, TITLE 56, IDAHO
3 CODE, BY THE ADDITION OF A NEW SECTION 56-209m, IDAHO CODE, TO GOVERN THE
4 CALCULATIONS OF MEDICAID REIMBURSEMENTS WHEN MEDICARE COVERAGE IS PRO-
5 VIDED.
6 Be It Enacted by the Legislature of the State of Idaho:
7 SECTION 1. That Chapter 2, Title 56, Idaho Code, be, and the same is
8 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
9 ignated as Section 56-209m, Idaho Code, and to read as follows:
10 56-209m. PATIENT SHARE OF COST -- MEDICAID. An individual who is receiv-
11 ing nursing home care as a recipient of medicaid, and whose situation tempo-
12 rarily changes such that he becomes an eligible recipient of medicare part A,
13 shall continue to pay the patient share of cost as previously determined by
14 the department and as if the recipient continued to be a medicaid only recipi-
15 ent. If the share of cost for a medicaid recipient receiving skilled nursing
16 facility care under medicare part A exceeds the medicare coinsurance or
17 copayment for a given month, the excess shall carry over to the next month and
18 be applied to the amount billed to medicaid on any subsequent claim. The
19 patient share of cost is defined as the amount of personal income determined
20 by the department to be owed by a recipient to a provider to offset the cost
21 of care paid for under medicaid.
22 Any excess share of cost remaining after medicare part A coinsurance has
23 been paid shall then be applied to any medicare part B coinsurance billable to
24 medicaid. The amount payable by medicaid to the provider shall be equal to and
25 no greater than the amount of medicare coinsurance shown on the medicare
26 explanation of benefits, less any share of cost amount paid by the recipient.
STATEMENT OF PURPOSE
RS 12150
This legislation provides a cost savings to the state in a way
that does not hurt patient care or facility reimbursement.
Although it changes what cuts are made, this legislation does not
change the Health and Welfare budget that was approved by JFAC.
Passage of this legislation will allow the Department of Health
and Welfare to access a Medicaid patient s resource amount
(social security) when in a Medicare Part A stay in a Skilled
Nursing Facility. It also requires the department to continue to
pay the Medicare Part B co-insurance amounts.
Fiscal Impact
There are no costs connected with this proposed legislation.
Contact:
Robert Vande Merwe
Idaho Health Care Association
(208) 343-9735
STATEMENT OF PURPOSE/FISCAL NOTE S 1484