2012 Session

Budget Amendments - SB30 (Committee Approved)

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Report on Impact of SSI Eligibility Reduction (language only)

Item 307 #5s

Item 307 #5s

Health And Human Resources
Medical Assistance Services, Department of

Page 238, line 45, before "The", insert:
"1.  Prior to the implementation of the reduction in paragraph 2, the Director of the Department of Medical Assistance Services shall provide a detailed report and analysis of the impact of the
reduction of income eligibility from 300 percent to 250 percent of Supplemental Security Income (SSI).  The report shall include a comprehensive review and analysis of the estimated savings, costs and effects of the eligibility change.  The report shall be based on current enrollment in nursing homes, other institutions, and community-based waivers including the income level of those enrollees.  The report shall include a projection of future needs for nursing homes and community-based waivers, the estimated impact on admission to a nursing home or other institution, and the cost of care in each waiver compared to institutional care.  Further, the report shall include the impact of patient-pay requirements on the Medicaid cost of institutional and community-based care for those with income at or above 250 percent of the SSI payment level, and the availability and expected use of the medically needy eligibility process by those with income at or above 250 percent of the SSI payment level to obtain Medicaid coverage for institutional and community-based care.  Finally, the report shall evaluate the impact of this eligibility change on compliance with the terms of the Commonwealth's settlement agreement with the U.S. Department of Justice, and available options for long-term care services for those who would no longer qualify for Medicaid services because of this income eligibility change.  The final report shall be provided to the Chairmen of the Senate Finance and House Appropriations Committees as well as the Joint Commission on Health Care no later than October 1, 2012.

(This language amendment requires a report on the implications of reducing the income eligibility limit for Medicaid long-term care services effective January 1, 2014 prior to implementation of this policy change. Currently, elderly or disabled individuals with income up to 300 percent of the federal Supplemental Security Income (SSI) payment level ($2,094 per month) may be eligible for Medicaid long-term care services. The introduced budget reduces the income eligibility limit to 250 percent of the SSI payment level ($1,745 per month) effective January 1, 2014, potentially resulting in 4,562 fewer individuals qualifying for Medicaid funded nursing home care or long-term care waiver services. This report will provide additional information for policy makers to consider before implementing this change.)