FIRST REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
94TH GENERAL ASSEMBLY
Reported from the Special Committee on Ticket to Work February 7, 2007 with recommendation that House Committee Substitute for House Bill Nos. 40, 116 & 367 Do Pass. Referred to the Committee on Rules pursuant to Rule 25(21)(f).
D. ADAM CRUMBLISS, Chief Clerk
AN ACT
To repeal sections 135.096, 660.546, 660.547, 660.549, 660.551, 660.553, 660.555, and 660.557, RSMo, and to enact in lieu thereof five new sections relating to long-term care insurance.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 135.096, 660.546, 660.547, 660.549, 660.551, 660.553, 660.555, and 660.557, RSMo, are repealed and five new sections enacted in lieu thereof, to be known as sections 135.096, 208.690, 208.692, 208.694, and 208.696, to read as follows:
135.096. 1. In order to promote personal financial responsibility for long-term health care in this state, for all taxable years beginning after December 31, 1999, a resident individual may deduct from such individual's Missouri taxable income an amount equal to fifty percent of all nonreimbursed amounts paid by such individual for qualified long-term care insurance premiums to the extent such amounts are not included the individual's itemized deductions. For all taxable years beginning after December 31, 2006, a resident individual may deduct from each individual's Missouri taxable income an amount equal to one hundred percent of all nonreimbursed amounts paid by such individual for qualified long-term care insurance premiums to the extent such amounts are not included in the individual's itemized deductions. A married individual filing a Missouri income tax return separately from his or her spouse shall be allowed to make a deduction pursuant to this section in an amount equal to the proportion of such individual's payment of all qualified long-term care insurance premiums. The director of the department of revenue shall place a line on all Missouri individual income tax returns for the deduction created by this section.
2. For purposes of this section, "qualified long-term care insurance" means any policy which meets or exceeds the provisions of sections 376.1100 to 376.1118, RSMo, and the rules and regulations promulgated pursuant to such sections for long-term care insurance.
208.690. 1. This act shall be known and may be cited as the "Missouri Long-Term Care Partnership Act".
2. The director of the Missouri department of social services shall, in conjunction with the director of the Missouri department of insurance, financial institutions and professional registration, coordinate a qualified state long-term care insurance partnership program to provide incentives for the purchase of private long-term care insurance to finance long-term care. Under such program, an individual may purchase a qualified state long-term care insurance partnership policy in accordance with the requirements of Section 1917(b) of the federal Social Security Act, as amended, and any applicable federal guidelines to provide a mechanism for individuals to qualify for coverage of the cost of their long-term care needs under the state Medicaid program without first being required to substantially exhaust their resources. The program shall be established by filing an amendment to the state Medicaid plan with the Secretary of the federal Department of Health and Human Services.
208.692. The department of social services may promulgate rules in accordance with the requirements of Section 1917(b) of the federal Social Security Act, as amended, and applicable federal guidelines to implement the provisions of sections 208.690 to 208.699. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2007, shall be invalid and void.
208.694. 1. The director of the department of insurance, financial institutions and professional registration may certify qualified state long-term care insurance partnership policies that meet the applicable provisions of the NAIC Long-Term Care Insurance Model Act and Regulation as specified in 42 U.S.C. Section 1917 (b) and Section 6021 of the Federal Deficit Reduction Act of 2005.
2. The director of the department of insurance, financial institutions and professional registration may promulgate rules to implement applicable provisions of a qualified state long-term care partnership in accordance with the requirements of Section 1917(b) of the federal Social Security Act, as amended, and any applicable federal guidelines. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2007, shall be invalid and void.
208.696. The director of the department of insurance, financial institutions and professional registration, in conjunction with the director of the department of social services, shall submit a report on the progress and effectiveness of the program to the general assembly on September 1, 2008, and on January first each year thereafter.
[660.546. 1. The department of social services shall coordinate a program entitled the "Missouri Partnership for Long-term Care" whereby private insurance and Medicaid funds shall be combined to finance long-term care. Under such program, an individual may purchase a precertified long-term care insurance policy in an amount commensurate with his resources as defined pursuant to the Medicaid program. Notwithstanding any provision of law to the contrary, the resources of such an individual, to the extent such resources are equal to the amount of long-term care insurance benefit payments as provided in section 660.547, shall not be considered by the department of social services in a determination of:
(1) His eligibility for Medicaid;
(2) The amount of any Medicaid payment.
Any subsequent recovery of a payment for medical services by the state shall be as provided by federal law.
2. Notwithstanding any provision of law to the contrary, for purposes of recovering any medical assistance paid on behalf of an individual who was allowed an asset or resource disregard based on such long-term care insurance policy, the definition of estate shall be expanded to include any other real or personal property and other assets in which the individual has any legal title or interest at the time of death, to the extent of such interest, including such assets conveyed to a survivor, heir, or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement.]
[660.547. The department of social services shall request appropriate waiver or waivers from the Secretary of the federal Department of Health and Human Services to permit the use of long-term care insurance for the preservation of resources pursuant to section 660.546. Such preservation shall be provided, to the extent approved by the federal Department of Health and Human Services, for any purchaser of a precertified long-term care insurance policy delivered, issued for delivery or renewed within five years after receipt of the federal approval of the waiver, and shall continue for the life of the original purchaser of the policy, provided that he maintains his obligations pursuant to the precertified long-term care insurance policy. Insurance benefit payments made on behalf of a claimant, for payment of services which would be covered under section 208.152, RSMo, shall be considered to be expenditures of resources as required under chapter 208, RSMo, for eligibility for medical assistance to the extent that such payments are:
(1) For services Medicaid approves or covers for its recipients;
(2) In an amount not in excess of the charges of the health services provider;
(3) For nursing home care, or formal services delivered to insureds in the community as part of a care plan approved by a coordination, assessment and monitoring agency licensed pursuant to chapter 198, RSMo; and
(4) 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 director of the department of social services shall adopt regulations in accordance with chapter 536, RSMo, to implement the provisions of sections 660.546 to 660.557, relating to determining eligibility of applicants for Medicaid and the coverage requirements for long-term care benefits.]
[660.549. The department of social services shall establish an outreach program to educate consumers to:
(1) The mechanisms for financing long-term; and
(2) The asset protection provided under sections 660.546 to 660.557.]
[660.551. 1. The department of insurance shall precertify long-term care insurance policies which are issued by insurers who, in addition to complying with other relevant laws and regulations:
(1) Alert the purchaser to the availability of consumer information and public education provided by the division of aging and the department of insurance pursuant to sections 660.546 to 660.557;
(2) Offer the option of home- and community-based services in lieu of nursing home care;
(3) Offer automatic inflation protection or optional periodic per diem upgrades until the insured begins to receive long-term care benefits; provided, however, that such inflation protection or upgrades shall not be required of life insurance policies or riders containing accelerated long-term care benefits;
(4) Provide for the keeping of records and an explanation of benefits reports to the insured and the department of insurance on insurance payments which count toward Medicaid resource exclusion; and
(5) Provide the management information and reports necessary to document the extent of Medicaid resource protection offered and to evaluate the Missouri partnership for long-term care including, but not limited to, the information listed in section 660.553.
Included among those policies precertified under this section shall be life insurance policies which offer long-term care either by rider or integrated into the life insurance policy.
2. No policy shall be precertified pursuant to sections 660.546 to 660.557, if it requires prior hospitalization or a prior stay in a nursing home as a condition of providing benefits.
3. The department of insurance may adopt regulations to carry out the provisions of sections 660.546 to 660.557.]
[660.553. The department of insurance shall provide public information to assist individuals in choosing appropriate insurance coverage, and shall establish an outreach program to educate consumers as to:
(1) The need for long-term; and
(2) The availability of long-term care
insurance.]
[660.555. The director of the department of insurance each year, on January first shall report in writing to the department of social services the following information:
(1) The success in implementing the provisions of sections 660.546 to 660.557;
(2) The number of policies precertified pursuant to sections 660.546 to 660.557;
(3) The number of individuals filing consumer complaints with respect to precertified policies; and
(4) The extent and type of benefits paid, in the aggregate, under such policies that could count toward Medicaid resource protection.]
[660.557. The director of the department of social services shall request the federal approvals necessary to carry out the purposes of sections 660.546 to 660.557. Each year on January first, the director of the department of social services shall report in writing to the general assembly on the progress of the program. Such report will include, but not be limited to:
(1) The success in implementing the provisions of sections 660.546 to 660.557;
(2) The number of policies precertified pursuant to sections 660.546 to 660.557;
(3) The number of individuals filing consumer complaints with respect to precertified policies;
(4) The extent and type of benefits paid, in the aggregate, under such policies that could count toward Medicaid resource protection;
(5) Estimates of impact on present and future Medicaid expenditures;
(6) The cost effectiveness of the program; and
(7) A recommendation regarding the appropriateness of continuing the program.]
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