Text: SSB02167 Text: SSB02169 Text: SSB02100 - SSB02199 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 249A.5, subsection 2, paragraph f, Code 1 2 Supplement 1995, is amended to read as follows: 1 3 f. (1) If a debt is due under this subsection from the 1 4 estate of a recipient, the administrator of the nursing 1 5 facility, intermediate care facility for the mentally 1 6 retarded, or mental health institute in which the recipient 1 7 resided at the time of the recipient's death, and the personal 1 8 representative of the recipient, if applicable, shall report 1 9 the death to the department within ten days of the death of 1 10 the recipient.For the purposes of this paragraph, "personal1 11representative" means a person who filed a medical assistance1 12application on behalf of the recipient or who manages the1 13financial affairs of the recipient.1 14 (2) If a personal representative or executor of an estate 1 15 makes a distribution either in whole or in part of the 1 16 property of an estate to the heirs, next of kin, distributees, 1 17 legatees, or devisees without having executed the obligations 1 18 pursuant to section 633.425, the personal representative or 1 19 executor may be held personally liable for the amount of 1 20 medical assistance paid on behalf of the recipient, to the 1 21 full value of any property belonging to the estate which may 1 22 have been in the custody or control of the personal 1 23 representative or executor. 1 24 (3) For the purposes of this paragraph, "executor" means 1 25 executor as defined in section 633.3, and "personal 1 26 representative" means a person who filed a medical assistance 1 27 application on behalf of the recipient or who manages the 1 28 financial affairs of the recipient. 1 29 Sec. 2. Section 249A.19, Code 1995, is amended to read as 1 30 follows: 1 31 249A.19 HEALTH CARE FACILITIES &endash; PENALTY. 1 32 The department shall adopt rules pursuant to chapter 17A to 1 33 assess and collect, with interest, a civil penalty for each 1 34 day a health care facility which receives medical assistance 1 35 reimbursements does not comply with the requirements of the 2 1 federal Social Security Act, } 1919, as codified in 42 U.S.C. 2 2 } 1396r. A civil penalty shall not exceed the amount 2 3 authorized undersection 135C.3642 C.F.R. } 488.438 for 2 4 health care facility violations. Any moneys collected by the 2 5 department pursuant to this section shall be applied to the 2 6 protection of the health or property of the residents of the 2 7 health care facilities which are determined by the state or by 2 8 the federal health care financing administration to be out of 2 9 compliance. The purposes for which the collected moneys shall 2 10 be applied may include payment for the costs of relocation of 2 11 residents to other facilities, maintenance or operation of a 2 12 health care facility pending correction of deficiencies or 2 13 closure of the facility, and reimbursing residents for 2 14 personal funds lost. If a health care facility is assessed a 2 15 civil penalty under this section, the health care facility 2 16 shall not be assessed a penalty under section 135C.36 for the 2 17 same violation. 2 18 Sec. 3. Section 249F.1, subsection 2, paragraph b, Code 2 19 1995, is amended to read as follows: 2 20 b. However, transfer of assets does not include the 2 21 following: 2 22 (1) Transfers to or for the sole benefit of the 2 23 transferor's spouse, including a transfer to a spouse by an 2 24 institutionalized spouse pursuant to section 1924(f)(1) of the 2 25 federal Social Security Act. 2 26 (2) Transfers, other than the transfer of a dwelling,to 2 27 or for the sole benefit of the transferor's child who is blind 2 28 or disabled as defined in section 1614 of the federal Social 2 29 Security Act. 2 30 (3) Transfer of a dwelling, which serves as the 2 31 transferor's home as defined in 20 C.F.R. } 416.1212, to a 2 32 child of the transferor under twenty-one years of age. 2 33 (4) Transfer of a dwelling, which serves as the 2 34 transferor's home as defined in 20 C.F.R. } 416.1212, after 2 35 the transferor is institutionalized, to either of the 3 1 following: 3 2 (a) A sibling of the transferor who has an equity interest 3 3 in the dwelling and who was residing in the dwelling for a 3 4 period of at least one year immediately prior to the date the 3 5 transferor became institutionalized. 3 6 (b) A child of the transferor who was residing in the 3 7 dwelling for a period of at least two years immediately prior 3 8 to the date the transferor became institutionalized and who 3 9 provided care to the transferor which permitted the transferor 3 10 to reside at the dwelling rather than in an institution or 3 11 facility. 3 12 (5) Transfers of less than two thousand dollars.For3 13purposes of this chapter,However, all transfers by the same 3 14 transferor during a calendar yearwillshall be aggregated. 3 15 If a transferor transfers property to more than one transferee 3 16 during a calendar year, the two thousand dollar exemption 3 17 shall be divided equally between the transferees. 3 18 (6) Transfersof propertythat would, at the time of the 3 19 transferor's application for medical assistance, have been 3 20 exempt from consideration as a resource if it had been 3 21 retained by the transferor, pursuant to 42 U.S.C. } 1382b(a), 3 22 as implemented by regulations adopted by the secretary of the 3 23 United States department of health and human services, and3 24pursuant to section 561.16 and chapter 627. 3 25 (7) Transfers to a trust established solely for the 3 26 benefit of the transferor's child who is blind or permanently 3 27 and totally disabled as defined in the federal Social Security 3 28 Act, section 1614, as codified in 42 U.S.C. } 1382b. 3 29 (8) Transfers to a trust established solely for the 3 30 benefit of an individual under sixty-five years of age who is 3 31 disabled, as defined in the federal Social Security Act, 3 32 section 1614, as codified in 42 U.S.C. } 1382b. 3 33 (9) Transfer of a homestead, as defined in sections 561.1, 3 34 561.2, and 561.3. 3 35 Sec. 4. Section 249F.2, Code 1995, is amended to read as 4 1 follows: 4 2 249F.2 CREATION OF DEBT. 4 3 A transfer of assets creates a debt due and owing to the 4 4 department of human services from the transferee in an amount 4 5 equal to medical assistance provided to or on behalf of the 4 6 transferor, on or after the date of the transfer of assets, 4 7 but not exceeding the fair market value of the assetswhich4 8are not exempt under section 249F.1at the time of the 4 9 transfer. 4 10 EXPLANATION 4 11 This bill makes several changes related to medical 4 12 assistance. 4 13 The bill requires any personal representative or the 4 14 executor of an estate of a medical assistance recipient, whose 4 15 estate is subject to recovery under the medical assistance 4 16 program, to make distribution of the estate to the department 4 17 of human services prior to distributions to others who have 4 18 claims to assets. 4 19 The bill also conforms references in the Code to current 4 20 federal citations relating to nursing facility fines which are 4 21 higher than those required under current state law. The bill 4 22 conforms the Code to current federal requirements relating to 4 23 transfers of assets under the medical assistance program 4 24 including the defining of "homestead" for the purposes of 4 25 exempting the homestead from transfer of assets limitations 4 26 and deleting the references to exemptions for other purposes. 4 27 BACKGROUND STATEMENT 4 28 SUBMITTED BY THE AGENCY 4 29 PERSONAL LIABILITY OF PERSONAL REPRESENTATIVE. 4 30 This change requires any personal representative or the 4 31 executor of a deceased medical assistance recipient's estate, 4 32 which is subject to recovery under section 249A.5, to make 4 33 distribution of the estate to the department of human services 4 34 before making distributions to heirs, next of kin, or any 4 35 others listed as a lower priority claim in Code section 5 1 633.425. 5 2 Attorneys probating an estate are required to inform all 5 3 possible claimants that an estate is being opened. In some 5 4 instances a medical assistance recipient may own an interest 5 5 in real or personal property and an estate will not be 5 6 probated for the recipient. In some cases the estate is small 5 7 and the family does not probate the estate but divides the 5 8 estate before a claim is filed. The department is unable to 5 9 singularly track the amount in the estate that could be used 5 10 to repay the department for medical assistance services paid 5 11 on the recipient's behalf. Estate recovery action may be 5 12 waived until a future time because recovery would affect the 5 13 amount of inheritance to a recipient's surviving spouse or 5 14 minor, blind, or disabled child. 5 15 Implementing this change could result in an increase of 5 16 recovery of small estates, estates that consist of only liquid 5 17 assets, and other situations not subject to probate or where 5 18 probate is avoided. 5 19 The change may require additional staff time and postage 5 20 costs to forward reports to the department's contractor who is 5 21 handling the estate recovery program. 5 22 NURSING FACILITY FINES. 5 23 This language conforms Code language to the fine limit 5 24 reference for nursing facilities required under federal 5 25 regulation effective July 1, 1995. The regulations require 5 26 certain levels of civil penalties to be imposed on facilities 5 27 with certain types of deficiencies. In order to collect the 5 28 higher fines a change to the Iowa Code is required. 5 29 The federal fines may exceed the fines established in 5 30 chapter 135C which might result in increased fines to nursing 5 31 facilities. 5 32 The department of human services and the department of 5 33 inspections and appeals work jointly to establish the fines 5 34 imposed on certified facilities. The department of human 5 35 services is also establishing an account to use the nursing 6 1 facilities' fines under this section. 6 2 TRANSFERS OF ASSETS &endash; MEDICAL ASSISTANCE DEBT (CHAPTER 6 3 249F). 6 4 This change conforms transfer of asset requirements to 6 5 federal regulations and clarifies that transfers of a 6 6 homestead are exempt from application of Iowa Code chapter 6 7 249F if the transfer is exempt under federal regulations. 6 8 Implementing this change should result in reduction of 6 9 administrative complexity and a clearer understanding of the 6 10 intent of the Code. Reduced complexity may result in a slight 6 11 increase in the number of referrals that staff are able to 6 12 process. 6 13 No additional staff time is necessary; this change should 6 14 increase efficiency for those departments implementing the 6 15 provisions. 6 16 LSB 3293DP 76 6 17 pf/sc/14.2
Text: SSB02167 Text: SSB02169 Text: SSB02100 - SSB02199 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
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