HF 1828

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; requiring counties to
process certain medical assistance applications within
timelines; amending Minnesota Statutes 2004, section
256B.19, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2004, section 256B.19, is
amended by adding a subdivision to read:

new text begin Subd. 2d. new text end

new text begin Obligation of local agency to process medical
assistance applications within established timelines. new text end

new text begin (a)
Except as provided in paragraph (b), when an individual submits
an application for medical assistance and the applicant's
eligibility is based on disability or on being age 65 or older,
the county must determine the applicant's eligibility and mail a
notice of its decision to the applicant within: (1) 60 days
from the date of the application for an individual whose
eligibility is based on disability; and (2) 45 days from the
date of the application for an individual whose eligibility is
based on being age 65 or older.
new text end

new text begin (b) The county must determine eligibility and mail a notice
of its decision within the time frames in paragraph (a), except
in the following circumstances:
new text end

new text begin (1) the county cannot make a determination because, despite
reasonable efforts by the county to communicate what is
required, the applicant or an examining physician delays or
fails to take a required action; or
new text end

new text begin (2) there is an administrative or other emergency beyond
the county's control.
new text end

new text begin For purposes of clause (2), a staffing shortage does not
constitute an emergency beyond the county's control. For either
of the events in clause (1) or (2), the county must document in
the applicant's case record the reason for delaying beyond the
established time frames.
new text end

new text begin (c) The county must not use the time frames in paragraph
(a) as a waiting period before determining eligibility or as a
reason for denying eligibility because it has not determined
eligibility within the established time frames.
new text end

new text begin (d) Effective July 1, 2005, unless one of the exceptions
listed under paragraph (b) applies, if a county fails to comply
with paragraph (a) and the applicant ultimately is determined to
be eligible for medical assistance, the county is responsible
for the entire cost of medical assistance services provided to
the applicant by a nursing facility and not paid for by federal
funds, from and including the first date of eligibility through
the date on which the county mails written notice of its
decision on the application. The applicable facility will bill
and receive payment directly from the commissioner in customary
fashion, and the commissioner shall deduct any obligation
incurred under this paragraph from the amount due to the local
agency under subdivision 1.
new text end

new text begin (e) This subdivision supersedes subdivision 1, clause (2),
if both apply to an applicant.
new text end