HF 1768

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to human services; requiring counties to 
  1.3             process certain medical assistance applications within 
  1.4             timelines; amending Minnesota Statutes 2002, section 
  1.5             256B.19, by adding a subdivision. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2002, section 256B.19, is 
  1.8   amended by adding a subdivision to read: 
  1.9      Subd. 2d.  [OBLIGATION OF LOCAL AGENCY TO PROCESS MEDICAL 
  1.10  ASSISTANCE APPLICATIONS WITHIN ESTABLISHED TIMELINES.] (a) 
  1.11  Except as provided in paragraph (b), when an individual submits 
  1.12  an application for medical assistance and the applicant's 
  1.13  eligibility is based on disability or on being age 65 or older, 
  1.14  the county must determine the applicant's eligibility and mail a 
  1.15  notice of its decision to the applicant within:  (1) 60 days 
  1.16  from the date of the application for an individual whose 
  1.17  eligibility is based on disability; and (2) 45 days from the 
  1.18  date of the application for an individual whose eligibility is 
  1.19  based on being age 65 or older. 
  1.20     (b) The county must determine eligibility and mail a notice 
  1.21  of its decision within the time frames in paragraph (a), except 
  1.22  in the following circumstances: 
  1.23     (1) the county cannot make a determination because, despite 
  1.24  reasonable efforts by the county to communicate what is 
  1.25  required, the applicant or an examining physician delays or 
  2.1   fails to take a required action; or 
  2.2      (2) there is an administrative or other emergency beyond 
  2.3   the county's control.  
  2.4   For purposes of clause (2), a staffing shortage does not 
  2.5   constitute an emergency beyond the county's control.  For either 
  2.6   of the events in clause (1) or (2), the county must document in 
  2.7   the applicant's case record the reason for delaying beyond the 
  2.8   established time frames. 
  2.9      (c) The county must not use the time frames in paragraph 
  2.10  (a) as a waiting period before determining eligibility or as a 
  2.11  reason for denying eligibility because it has not determined 
  2.12  eligibility within the established time frames. 
  2.13     (d) Effective July 1, 2004, unless one of the exceptions 
  2.14  listed under paragraph (b) applies, if a county fails to comply 
  2.15  with paragraph (a) and the applicant ultimately is determined to 
  2.16  be eligible for medical assistance, the county is responsible 
  2.17  for the entire cost of medical assistance services provided to 
  2.18  the applicant by a nursing facility and not paid for by federal 
  2.19  funds, from and including the first date of eligibility through 
  2.20  the date on which the county mails written notice of its 
  2.21  decision on the application.  The applicable facility will bill 
  2.22  and receive payment directly from the commissioner in customary 
  2.23  fashion, and the commissioner shall deduct any obligation 
  2.24  incurred under this paragraph from the amount due to the local 
  2.25  agency under subdivision 1. 
  2.26     (e) This subdivision supersedes subdivision 1, clause (2), 
  2.27  if both apply to an applicant.