Sec. 17b-253. (Formerly Sec. 17-12r). Connecticut Partnership for Long-Term Care: Amendments to Medicaid regulations and state plan. Regulations.
Sec. 17b-253. (Formerly Sec. 17-12r). Connecticut Partnership for Long-Term Care: Amendments to Medicaid regulations and state plan. Regulations. (a)
The Department of Social Services shall seek appropriate amendments to its Medicaid
regulations and state plan to allow protection of resources and income pursuant to section
17b-252. Such protection shall be provided, to the extent approved by the federal Centers
for Medicare and Medicaid Services, for any purchaser of a precertified long-term care
policy and shall last for the life of the purchaser. Such protection shall be provided under
the Medicaid program or its successor program. Any purchaser of a precertified long-term care policy shall be guaranteed coverage under the Medicaid program or its successor program, to the extent the individual meets all applicable eligibility requirements
for the Medicaid program or its successor program. Until such time as eligibility requirements are prescribed for Medicaid's successor program, for the purposes of this subsection, the applicable eligibility requirements shall be the Medicaid program's requirements as of the date its successor program was enacted. The Department of Social
Services shall count insurance benefit payments toward resource exclusion to the extent
such payments (1) are for services paid for by a precertified long-term care policy; (2)
are for the lower of the actual charge and the amount paid by the insurance company;
(3) are for nursing home care, or formal services delivered to insureds in the community
as part of a care plan approved by an access agency approved by the Office of Policy
and Management and the Department of Social Services as meeting the requirements
for such agency as defined in regulations adopted pursuant to subsection (e) of section
17b-342; and (4) are for services provided after the individual meets the coverage requirements for long-term care benefits established by the Department of Social Services
for this program. The Commissioner of Social Services shall adopt regulations, in accordance with chapter 54, to implement the provisions of this subsection and sections
17b-251, 17b-252, 17b-254 and 38a-475 relating to determining eligibility of applicants
for Medicaid, or its successor program, and the coverage requirements for long-term
care benefits.
(b) The Commissioner of Social Services, after consultation with the Secretary of
the Office of Policy and Management, may enter into reciprocal agreements with other
states to extend the resource exclusions under section 17b-252 and subsection (a) of
this section to purchasers of qualified long-term care insurance policies issued in states
entering into such reciprocal agreements if such purchasers apply to the Medicaid program or its successor program. Such reciprocal agreements shall also allow purchasers
of precertified policies under section 38a-475 to receive a Medicaid resource exclusion
in states entering into such reciprocal agreements. The provisions of such reciprocal
agreements shall be effective for the life of a purchaser of a precertified policy. For the
purposes of this subsection, "qualified long-term care insurance policy" means a long-term care insurance policy approved through a program in another state that provides
a Medicaid resource exclusion or asset disregard substantially similar to the Medicaid
resource exclusion included in precertified policies and includes benefits substantially
similar to those included in a precertified policy.
(P.A. 89-352, S. 2, 6; P.A. 91-187, S. 2, 4; P.A. 93-262, S. 1, 87; P.A. 94-167, S. 2, 4; P.A. 95-160, S. 6, 69; P.A. 96-131, S. 2, 3; 96-139, S. 12, 13; P.A. 98-239, S. 21, 35; P.A. 03-19, S. 40.)
History: P.A. 91-187 changed deadline for purchasing policy providing protection under the program from December
31, 1994, to December 31, 1996; P.A. 93-262 authorized substitution of commissioner and department of social services
for commissioner and department of income maintenance, effective July 1, 1993; P.A. 94-167 removed deadline for
purchasing policy, effective June 7, 1994; Sec. 17-12r transferred to Sec. 17b-253 in 1995; P.A. 95-160 replaced a reference
to a coordination, assessment and monitoring agency with access agency, effective July 1, 1995; P.A. 96-131 inserted
references to Medicaid's "successor program", required such successor program to provide protection of resources and
income provided by Medicaid, guaranteed coverage under the Medicaid program or its successor program for any purchaser
of a precertified long-term care policy, with certain eligibility requirements, amended Subdiv. (1) to replace "Medicaid
approves or covers for its recipients" with "paid for by a precertified long-term care policy", effective May 29, 1996; P.A.
96-139 changed effective date of P.A. 95-160 but without affecting this section; P.A. 98-239 made technical changes in
existing section, designated as Subsec. (a), and added Subsec. (b) allowing commissioner, after consulting with the Secretary
of the Office of Policy and Management, to enter into reciprocal agreements with other states to extend the resource
exclusions under the program to purchasers of qualified long-term care insurance policies issued in those states if such
purchasers apply to the Medicaid program, providing that such reciprocal agreements shall allow purchasers of precertified
policies under Sec. 38a-475 to receive a Medicaid resource exclusion in states which enter into such agreements and
defining "qualified long-term care insurance policy", effective June 8, 1998; P.A. 03-19 replaced "Health Care Financing
Administration" with "Centers for Medicare and Medicaid Services" in Subsec. (a), effective May 12, 2003.
See Sec. 17b-251 re outreach program.
See Sec. 17b-252 re overview of program.
See Sec. 17b-254 re foundation funds and federal approval and report to General Assembly.
See Sec. 38a-475 re precertification of long-term care insurance policies.