S*0609(Rat #0114, Act #0071 of 1995)  General Bill, By Leatherman, Lander, 
Ryberg, Saleeby, J.V. Smith, H.S. Stilwell and Wilson
 A Bill to amend Section 43-7-460, Code of Laws of South Carolina, 1976,
 relating to the recovery from an estate for medical assistance paid under
 Medicaid, so as to further specify services considered to be medical
 assistance and to revise from whom recovery may be sought.

   03/07/95  Senate Introduced and read first time SJ-7
   03/07/95  Senate Referred to Committee on Medical Affairs SJ-7
   04/18/95  Senate Committee report: Favorable with amendment
                     Medical Affairs SJ-31
   04/19/95  Senate Amended SJ-126
   04/19/95  Senate Read second time SJ-126
   04/20/95  Senate Read third time and sent to House SJ-22
   04/25/95  House  Introduced and read first time HJ-12
   04/25/95  House  Referred to Committee on Medical, Military,
                     Public and Municipal Affairs HJ-12
   05/18/95  House  Committee report: Favorable Medical, Military,
                     Public and Municipal Affairs HJ-38
   05/23/95  House  Debate interrupted HJ-155
   05/23/95  House  Read second time HJ-160
   05/24/95  House  Read third time and enrolled HJ-9
   06/06/95         Ratified R 114
   06/12/95         Signed By Governor
   06/12/95         Effective date 06/12/95 and applies retroactively
                     to July 1, 1994
   08/09/95         Copies available
   08/09/95         Act No. 71

AN ACT TO AMEND SECTION 43-7-460, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE RECOVERY FROM AN ESTATE FOR MEDICAL ASSISTANCE PAID UNDER MEDICAID, SO AS TO FURTHER SPECIFY SERVICES CONSIDERED TO BE MEDICAL ASSISTANCE AND TO REVISE FROM WHOM RECOVERY MAY BE SOUGHT.

Whereas, Section 13612 of the federal Omnibus Budget Reconciliation Act of 1993 amended Title XIX of the Social Security Act so as to mandate that states "shall seek the adjustment or recovery of any medical assistance correctly paid on behalf of an individual under the State Medicaid plan" in the case of certain persons; and

Whereas, failure to adopt these changes would have meant that South Carolina's Medicaid program no longer complied with the federal laws governing Medicaid and the loss of federal Medicaid funding would be a financial disaster since the federal government provides seventy-one percent of the funds for the Medicaid program; and

Whereas, the General Assembly reluctantly complied with the federal mandate, with particular concerns about applying the mandated estate recovery provisions to payments for noninstitutional Medicaid services since this might discourage older patients from seeking needed medical care; and

Whereas, members of the United States Congress have introduced legislation to grant states the option of exempting payments for noninstitutional Medicaid services from the mandated estate recovery provisions. Now, therefore,

Be it enacted by the General Assembly of the State of South Carolina:

Medical assistance further defined

SECTION 1. Section 43-7-460(A)(2) of the 1976 Code, as added by Act 481 of 1994, is amended to read:

"(2) was fifty-five years of age or older when the individual received medical assistance, but only for medical assistance consisting of nursing facility services, home and community-based services, and hospital and prescription drug services provided to individuals in nursing facilities or receiving home and community-based services."

From whom medical assistance reimbursement may be sought

SECTION 2. Section 43-7-460 of the 1976 Code, as added by Act 481 of 1994, is amended by adding at the end:

"(G) Notwithstanding subsection (A)(2) upon the enactment of any amendments to federal law which grant states the option to exempt home and community-based services or other noninstitutional Medicaid services from the estate recovery provisions mandated by Section 13612 of the federal Omnibus Budget Reconciliation Act of 1993, the State Health and Human Services Finance Commission shall seek recovery of medical assistance paid under the Title XIX State Plan for Medical Assistance from the estate of an individual who:

(1) at the time of death was an inpatient in a nursing facility, intermediate care facility for the mentally retarded, or other medical institution if the individual is required, as a condition of receiving services in the facility under the state plan, to spend for costs of medical care all but a minimal amount of the person's income required for personal needs; or

(2) was fifty-five years of age or older when the individual received medical assistance but only for medical assistance consisting of nursing facility services."

Time effective

SECTION 3. This act takes effect upon approval by the Governor and applies retroactively to July 1, 1994.

Approved the 12th day of June, 1995.