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H0282......................................................by STATE AFFAIRS
MEDICAL INDIGENCY - Amends existing law relating to determinations of
medical indigency to further define resources of an applicant.
03/01 House intro - 1st rdg - to printing
03/02 Rpt prt - to Health/Wel
03/15 Rpt out - rec d/p - to 2nd rdg
03/16 2nd rdg - to 3rd rdg
03/17 3rd rdg - PASSED - 61-8-1
AYES -- Anderson, Andrus, Barraclough, Barrett, Bastian, Bayer,
Bedke, Bell, Black, Block, Boe, Bolz, Bradford, Cannon, Chadderdon,
Clark, Collins, Deal, Denney, Edmunson, Ellsworth, Eskridge,
Field(18), Field(23), Hart, Harwood, Henderson, Jaquet, Jones, Kemp,
Lake, Loertscher, Mathews, McGeachin, McKague, Miller, Mitchell,
Moyle, Nielsen, Nonini, Pasley-Stuart, Pence, Raybould, Roberts,
Rusche, Rydalch, Sali, Sayler, Schaefer, Shepherd(2), Shepherd(8),
Shirley, Skippen, Smith(24), Smylie, Snodgrass, Stevenson, Trail,
Wills, Wood, Mr. Speaker
NAYS -- Bilbao, Garrett, Henbest, LeFavour, Martinez, Ring, Ringo,
Smith(30)
Absent and excused -- Crow
Floor Sponsor - Loertscher
Title apvd - to Senate
03/18 Senate intro - 1st rdg - to Health/Wel
03/22 Rpt out - rec d/p - to 2nd rdg
03/23 2nd rdg - to 3rd rdg
03/24 3rd rdg - PASSED - 28-5-1, 1 vacancy
AYES -- Brandt, Broadsword, Bunderson, Burtenshaw, Cameron, Coiner,
Compton, Corder, Darrington, Davis, Gannon, Geddes, Goedde, Hill,
Jorgenson, Keough, Langhorst, Little, Lodge, Malepeai, McGee,
McKenzie, Pearce, Richardson, Schroeder, Stegner, Sweet, Williams
NAYS -- Burkett, Kelly, Marley, Stennett, Werk
Absent and excused -- Andreason, (District 21 seat vacant)
Floor Sponsor - McGee
Title apvd - to House
03/24 To enrol
03/28 Rpt enrol - Sp signed
03/29 Pres signed
03/30 To Governor
04/05 Governor signed
Session Law Chapter 281
Effective: 07/01/05
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature First Regular Session - 2005
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 282
BY STATE AFFAIRS COMMITTEE
1 AN ACT
2 RELATING TO DETERMINATIONS OF MEDICAL INDIGENCY; AMENDING SECTION 31-3502,
3 IDAHO CODE, TO FURTHER DEFINE "RESOURCES" OF AN APPLICANT.
4 Be It Enacted by the Legislature of the State of Idaho:
5 SECTION 1. That Section 31-3502, Idaho Code, be, and the same is hereby
6 amended to read as follows:
7 31-3502. DEFINITIONS. As used in this chapter, the terms defined in this
8 section shall have the following meaning, unless the context clearly indicates
9 another meaning:
10 (1) "Medically indigent" means any person who is in need of necessary
11 medical services and who, if an adult, together with his or her spouse, or
12 whose parents or guardian if a minor, does not have income and other resources
13 available to him from whatever source sufficient to pay for necessary medical
14 services. Nothing in this definition shall prevent the board of county commis-
15 sioners and administrator from requiring the applicant and obligated persons
16 to reimburse the county and the catastrophic health care costs program, where
17 appropriate, for all or a portion of their medical expenses, when investiga-
18 tion of their application pursuant to this chapter, determines their ability
19 to do so.
20 (2) "Hospital" means a facility licensed and regulated pursuant to sec-
21 tions 39-1301 through 39-1314, Idaho Code, excluding state institutions.
22 (3) "Dependent" means any person whom a taxpayer could claim as a depend-
23 ent under the income tax laws of the state of Idaho.
24 (4) "Applicant" means any person who is or may be requesting financial
25 assistance under this chapter.
26 (5) "Reimbursement rates" means the unadjusted medicaid rate of reim-
27 bursement for medical charges allowed pursuant to title XIX of the social
28 security act, as amended. For long-term care facilities, maximum
29 "reimbursement rates" means the unadjusted medicaid rate of reimbursement
30 allowed pursuant to the medical assistance program as determined by chapter 1,
31 title 56, Idaho Code, or the unadjusted medicare rate of reimbursement estab-
32 lished under title XVIII of the social security act, as amended, whichever is
33 greater.
34 (6) "Board" means the board of county commissioners.
35 (7) "Obligated persons" means those persons who are legally responsible
36 for an applicant.
37 (8) "County hospital" means any county approved institution or facility
38 for the care of sick persons.
39 (9) "Administrator" means the board of the catastrophic health care cost
40 program, as provided in section 31-3517, Idaho Code.
41 (10) "Catastrophic health care costs" means all necessary medical expenses
42 for services which are incurred by a recipient for which the reimbursement
43 rate exceeds in aggregate the sum of ten thousand dollars ($10,000) in any
2
1 twelve (12) consecutive month period.
2 (11) "Recipient" means an individual determined eligible for necessary
3 medical services under this chapter.
4 (12) "Resident" means a person with a home, house, place of abode, place
5 of habitation, dwelling or place where he or she actually lived for a consecu-
6 tive period of thirty (30) days or more within the state of Idaho. A resident
7 does not include a person who comes into this state for temporary purposes,
8 including, but not limited to, education, vacation, or seasonal labor. Entry
9 into active military duty shall not change a person's residence for the pur-
10 poses of this chapter. Those physically present within the following facili-
11 ties and institutions shall be residents of the county where they were resi-
12 dents prior to entering the facility or institution:
13 (a) Correctional facilities;
14 (b) Nursing homes or residential or assisted living facilities;
15 (c) Other medical facility or institution.
16 (13) "Emergency service" means a service provided for a medical condition
17 in which sudden, serious and unexpected symptoms of illness or injury are suf-
18 ficiently severe to necessitate or call for immediate medical care.
19 (14) "Provider" means any person, firm, or corporation certified or
20 licensed by the state of Idaho or holding an equivalent license or certifica-
21 tion in another state, that provides necessary medical services as it appears
22 on an application for assistance pursuant to this chapter.
23 (15) "Third party applicant" means a person other than an obligated person
24 who completes, signs and files an application on behalf of a patient.
25 (16) "Clerk" means the clerk of the board or his or her designee.
26 (17) "Resources" means all property, whether tangible or intangible, real
27 or personal, liquid or nonliquid, including, but not limited to, all forms of
28 public assistance, crime victim's compensation, worker's compensation, vet-
29 erans benefits, medicaid, medicare and any other property from any source for
30 which an applicant and/or an obligated person may be eligible or in which he
31 or she may have an interest. Resources shall include the ability of an appli-
32 cant and obligated persons to pay for necessary medical services over a period
33 of up to three five (35) years. For purposes of determining approval for medi-
34 cal indigency only, resources shall not include the value of the homestead on
35 the applicant or obligated persons' residence, a burial plot, exemptions for
36 personal property allowed in section 11-605(1) through (3), Idaho Code, and
37 additional exemptions allowed by county resolution.
38 (18) A. "Necessary medical services" means a requested or provided medi-
39 cal service required in order to identify or treat a medically indigent
40 person's health condition, illness or injury and is:
41 (a) Consistent with the symptoms, diagnosis or treatment of the med-
42 ical indigent's condition, illness or injury;
43 (b) In accordance with generally accepted standards of medical or
44 surgical practice then prevailing in the community where the services
45 were provided;
46 (c) Furnished on an outpatient basis whenever it is safe, efficient
47 and reasonable to do so;
48 (d) Not provided primarily for the convenience of the medically
49 indigent person or the provider;
50 (e) The standard, most economical service or item that can safely,
51 reasonably and ethically be provided.
52 B. Necessary medical services shall not include the following:
53 (a) Bone marrow transplants;
54 (b) Organ transplants;
55 (c) Elective, cosmetic and/or experimental procedures;
3
1 (d) Services related to, or provided by, residential and/or shelter
2 care facilities;
3 (e) Normal, uncomplicated pregnancies, excluding caesarean section,
4 and childbirth well-baby care;
5 (f) Medicare copayments and deductibles;
6 (g) Services provided by, or available to an applicant from state,
7 federal and local health programs; and
8 (h) Medicaid copayments and deductibles.
9 Provided however, each board may determine, by ordinance or resolution
10 duly adopted in its county, to include as necessary medical services addi-
11 tional services not covered in this section. Necessary medical services pro-
12 vided by this option shall not be paid by the catastrophic health care costs
13 program, and shall remain the liability of the respective county.
STATEMENT OF PURPOSE
RS 15061
The purpose of this legislation is to extend from three to five
years the ability of individuals to pay medical expenses before
the counties and the Catastrophic Fund are required to pay those
expenses.
FISCAL NOTE
It is estimated that this measure will result in a combined
reduction of $2,000,000 in county property tax dollars and
general funds; 60% being county funds and 40% being general
funds.
Contact
Name: Rep. Tom Loertscher
Phone: 208-331-1000
Name: Tony Poinelli
Agency: Idaho Association of Counties
Phone: 208-345-9126
STATEMENT OF PURPOSE/FISCAL NOTE H 282