2005 Legislation
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HOUSE BILL NO. 282 – Medical indignce/applicant resource


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Bill Status

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,
      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

Bill Text

  ]]]]              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
  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
  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;
  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 / Fiscal Impact

                       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

                           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

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