2002 Legislation
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SENATE BILL NO. 1484 – Medicaid rmbrsmnts/medicare coverag

SENATE BILL NO. 1484

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View Bill Text

View Statement of Purpose / Fiscal Impact



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Daily Data Tracking History



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

Bill Text


                                                                        
                                                                        
  ||||              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 / Fiscal Impact


                     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