Section 367-F. Partnership for long term care program  


Latest version.
  • 1. Definitions. As
      used in this  section:  (a)  "Medicaid  extended  coverage"  shall  mean
      eligibility  for  medical  assistance (i) without regard to the resource
      requirements of section three hundred sixty-six of this title, or in the
      case of an individual covered under an insurance policy  or  certificate
      described in subdivision two of this section that provided a residential
      health  care facility benefit less than three years in duration, without
      consideration of an amount of  resources  equivalent  to  the  value  of
      benefits received by the individual under such policy or certificate, as
      determined  under  the  rules  of  the  partnership  for  long-term care
      program; (ii) without regard to the recovery of medical assistance  from
      the  estates  of individuals and the imposition of liens on the homes of
      persons pursuant to section three hundred sixty-nine of this title, with
      respect to resources exempt from consideration pursuant to  subparagraph
      (i)  of  this paragraph; provided, however, that nothing in this section
      shall prevent the imposition of a lien or recovery against  property  of
      an  individual  on  account  of medical assistance incorrectly paid; and
      (iii) based on an income eligibility standard for married couples  equal
      to the amount of the minimum monthly maintenance needs allowance defined
      in paragraph (h) of subdivision two of section three hundred sixty-six-c
      of  this  title,  and  for  single individuals equal to one-half of such
      amount; provided, however, that the commissioner of health shall not  be
      required  to implement the provisions of this subparagraph if the use of
      such income eligibility standards will  result  in  a  loss  of  federal
      financial  participation  in  the  costs  of  Medicaid extended coverage
      furnished  in  accordance  with  subparagraphs  (i)  and  (ii)  of  this
      paragraph.
        (b)  "Long  term  care  services" shall include, but not be limited to
      care, treatment,  maintenance,  and  services:  provided  in  a  nursing
      facility  licensed  under article twenty-eight of the public health law;
      provided by a home care services agency, certified home health agency or
      long term home health care program, as  defined  in  section  thirty-six
      hundred  two  of  the public health law; provided by an adult day health
      care program in accordance with regulations of the department of health;
      or provided by a personal care provider licensed  or  regulated  by  any
      other  state  or local agency; and such other services for which medical
      assistance  is  otherwise  available  under  this  chapter   which   are
      designated  as  long  term  care  services  in law or regulations of the
      department of health.
        2. Notwithstanding any inconsistent provision of this chapter  or  any
      other  law  to  the contrary, the partnership for long term care program
      shall provide Medicaid extended coverage to a person receiving long term
      care services  if  there  is  federal  participation  pursuant  to  such
      treatment  and such person: (a) is or was covered by an insurance policy
      or certificate providing coverage for long term  care  which  meets  the
      applicable  minimum benefit standards of the superintendent of insurance
      and other requirements for approval of participation under the  program;
      and,  (b)  has  exhausted  the  coverage and benefits as required by the
      program.
        3. Notwithstanding any inconsistent provision of this chapter  or  any
      other  law  to the contrary, the commissioner of health, in consultation
      with the superintendent of insurance and the director of the budget, may
      enter into reciprocal agreements  with  other  states  which  administer
      partnership  for  long  term  care  programs  under  which purchasers of
      policies in those states with comparable benefits to policies  available
      in  this  state shall be eligible for Medicaid extended coverage in this
      state so long as purchasers of policies in this  state  with  comparable
    
      benefits to policies available in such state or states shall be eligible
      for Medicaid extended coverage in such state or states.