2023 -- H 5996

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LC002053

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HUMAN SERVICES -- HEALTHCARE ASSISTANCE FOR WORKING

PEOPLE WITH DISABILITIES

     Introduced By: Representatives Spears, Tanzi, Boylan, Fenton-Fung, Donovan,
Speakman, and McGaw

     Date Introduced: March 01, 2023

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 40-8.7-6 of the General Laws in Chapter 40-8.7 entitled "Healthcare

Assistance for Working People with Disabilities" is hereby amended to read as follows:

     40-8.7-6. Eligibility.

     (a) To be eligible for benefits under the Medicaid buy-in program:

     (1) The person shall be an individual with disabilities as defined in § 40-8.7-4, but without

regard to his or her ability to engage in substantial gainful activity, as specified in the Social

Security Act, 42 U.S.C. § 423(d)(4);

     (2) The person shall be employed as defined in § 40-8.7-4;

     (3) The person’s net accountable income shall not exceed two hundred fifty percent (250%)

of the federal poverty level, taking into account the SSI program disregards and impairment-related

work expenses as defined in 42 U.S.C. § 1396a(r)(2);

     (4) A maximum of ten thousand dollars ($10,000) of available resources for an individual

and twenty thousand dollars ($20,000) for a couple shall be disregarded as shall any additional

resources held in a retirement account, in a medical savings account, or any other account, related

to enhancing the independence of the individual and approved under rules to be adopted by the

department; and

     (5) The person shall be a current medical assistance recipient under § 40-8.5-1 [CNIL] or

§ 40-8-3(5)(v) [MNIL]; or shall meet income, assets, (except as modified by subsection (a)(4) of

this section) and eligibility requirements for the medical assistance program under § 40-8.5-1

[CNIL] or § 40-8-3(5)(v) [MNIL], as such requirements are modified and extended by this chapter.

     (b) Appeals Process. The director or designee shall review each application filed in

accordance with regulations, and shall make a determination of whether the application will be

approved and the extent of the benefits to be made available to the applicant, and shall, within thirty

(30) days after the filing, notify the applicant, in writing, of the determination. If the application is

rejected, the applicant shall be notified the reason for the denial. The director may at any time

reconsider any determination. Any applicant for or recipient of benefits aggrieved because of a

decision, or delay in making a decision, shall be entitled to an appeal and shall be afforded

reasonable notice and opportunity for a fair hearing conducted by the director, pursuant to chapter

8 of this title.

     SECTION 2. Section 40-8-3 of the General Laws in Chapter 40-8 entitled "Medical

Assistance" is hereby amended to read as follows:

     40-8-3. Eligibility requirements.

     Medical care benefits shall be provided under this chapter to at least any person:

     (1) Who has attained the age of sixty-five (65) years; or

     (2) Who has no vision or whose vision is so defective as to prevent performance of ordinary

activities for which eyesight is essential; or

     (3) Who is at least eighteen (18) years of age and who is permanently and totally disabled;

or

     (4) Who is under the age of eighteen (18) years, and who has been deprived of parental

support or care by reason of the death, continued absence from the home, unemployment, or

physical or mental incapacity of a parent (called hereafter “dependent child”) and who is living

with a relative in a place of residence maintained by one or more of these relatives as his or her or

their own home, or is in foster boarding care; or

     (5) The relative as defined in subsection (8) of § 40-8-2, with whom the dependent child is

living; provided the person:

     (i) Is a resident of this state; and

     (ii) Is not receiving public assistance under the provisions of § 40-5.1-9(b) [repealed] or §

40-6-27; and

     (iii) Is not an inmate of a public institution other than as a patient in a medical institution;

and

     (iv) Is not a patient in an institution for tuberculosis or mental disease, unless the person

has attained the age of sixty-five (65) years; provided, however, that this clause shall become void

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and of no effect if and when legislation enacted by the Congress of the United States shall become

effective providing for payments for medical care on behalf of persons who have not attained the

age of sixty-five (65) years who are patients in an institution for tuberculosis or mental disease; and

     (v) Has insufficient income and resources. The department shall establish income and

resource rules, regulations, and limits in accordance with Title XIX of the federal Social Security

Act, 42 U.S.C. § 1396 et seq., as applicable to the medically needy only applicants and recipients.

The income limits established by the department must be more than the AFDC standard in effect

on July 16, 1996, under the Rhode Island state plan approved under part A of Title IV of the federal

Social Security Act, 42 U.S.C. § 601 et seq., but shall not be more than one hundred thirty-three

and one-third percent (133⅓%) of the AFDC standard in effect on July 16, 1996, under the Rhode

Island state plan approved under part A of Title IV of the federal Social Security Act; provided,

however, that subject to the maximum percentage increase allowable under § 1931(b)(2)(B), the

department shall increase the income limits on July 1, 1999, by six and six-tenths percent (6.6%),

and on January 1, of each year commencing in the year 2000 by a percentage equal to the annual

federal adjustment percentage as determined under the provisions of Title XVI of the federal Social

Security Act, 42 U.S.C. § 1381 et seq. The department shall establish resource limits equal to two

thousand dollars ($2,000) for an individual and three thousand dollars ($3,000) for a family.

Provided, however, the department shall apply to the United States Department of Health and

Human Services for a waiver relating to application of the reduced resource limit, and subject to

the granting of the waiver by the Secretary of the United States Department of Health and Human

Services, the resource limit shall be applied to all applicants who: (A) Become eligible for benefits

under this chapter on or after the effective date of this amendment and (B) Who were not receiving

benefits under this chapter prior to July 1, 1993. In the event the secretary does not approve the

waiver request, the current department regulations relating to resource limits shall remain in effect

for all eligible beneficiaries. Provided, however, on and after July 1, 2023, eligible recipients shall

not be subject to individual or family resource limits.

     For the purposes of this subsection, a vehicle necessary to transport a family member with

a disability, where the vehicle is specially equipped to meet the specific needs of the person with a

disability or if the vehicle is a special type of vehicle that makes it possible to transport the person

with the disability, shall not be counted as resources of the applicants and recipients.

     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES -- HEALTHCARE ASSISTANCE FOR WORKING

PEOPLE WITH DISABILITIES

***

     This act would remove the requirement that a person’s net accountable income does not

exceed two hundred fifty percent (250%) of the federal poverty level and that an individual

maintain a maximum of ten thousand dollars ($10,000) for an individual and twenty thousand

dollars ($20,000) for a couple, in order to qualify for the Medicaid buy-in program. This act would

further provide that as of July 1, 2023, eligible recipients would not be subject to individual or

family resource limits in order to qualify for Medicaid.

     This act would take effect upon passage.

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