Amendment #15 to H4178

Supporting Access To Community Care For Nursing Home Eligible Older Adults

Ms. Higgins of Leominster moves to amend the amendment by adding the following new section:-

Section XX.  Subsection (5) of section 25 of Chapter 118E of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking out the second paragraph, contained in lines 56 through 61, and inserting in place thereof the following paragraph:-

In any case where the monthly income of an applicant or recipient is in excess of the exemptions allowed, the applicant or recipient, if otherwise eligible for Medicaid under this chapter, shall be liable to pay to the provider of medical care or service an amount which shall be equal to the excess income for a period of six consecutive months, which includes the period when such service was provided, except if the individual is an applicant or recipient for home or community-based services pursuant to a waiver granted under 42 USC 1396a(10)(A)(ii)(VI) or a Program of All Inclusive Care for the Elderly (PACE), under 42 USC 1396u-4 or 42 USC 1395eee, the applicant or recipient shall be liable to pay to the provider of medical care or service an amount which shall be equal to the excess income reduced by the difference between the applicable MassHealth deductible-income standard and 300 percent of the federal benefit rate; provided, however, this exception shall not apply to individuals eligible for the “special income eligibility group,” the requirements for which are established under 42 CFR 435.217 and pursuant to federal regulations at 42 CFR 435.726 and 42 CFR 460.184.

Additional co-sponsor(s) added to Amendment #15 to H4178

Supporting Access To Community Care For Nursing Home Eligible Older Adults