N.Y. Social Services Law § 367-f: Partnership for long term care program

§ 367-f. Partnership for long term care program. 1. Definitions. As

used in this section: (a) "Medicaid extended coverage" shall mean

eligibility for medical assistance (i) without regard to the resource

requirements of section three hundred sixty-six of this title, or in the

case of an individual covered under an insurance policy or certificate

described in subdivision two of this section that provided a residential

health care facility benefit less than two years in duration, without

consideration of an amount of resources equivalent to the value of

benefits received by the individual under such policy or certificate, as

determined under the rules of the partnership for long-term care

program; (ii) without regard to the recovery of medical assistance from

the estates of individuals and the imposition of liens on the homes of

persons pursuant to section three hundred sixty-nine of this title, with

respect to resources exempt from consideration pursuant to subparagraph

(i) of this paragraph; provided, however, that nothing in this section

shall prevent the imposition of a lien or recovery against property of

an individual on account of medical assistance incorrectly paid; and

(iii) based on an income eligibility standard for married couples equal

to the amount of the minimum monthly maintenance needs allowance defined

in paragraph (h) of subdivision two of section three hundred sixty-six-c

of this title, and for single individuals equal to one-half of such

amount; provided, however, that the commissioner of health shall not be

required to implement the provisions of this subparagraph if the use of

such income eligibility standards will result in a loss of federal

financial participation in the costs of Medicaid extended coverage

furnished in accordance with subparagraphs (i) and (ii) of this

paragraph.

(b) "Long term care services" shall include, but not be limited to

care, treatment, maintenance, and services: provided in a nursing

facility licensed under article twenty-eight of the public health law;

provided by a home care services agency, certified home health agency or

long term home health care program, as defined in section thirty-six

hundred two of the public health law; provided by an adult day health

care program in accordance with regulations of the department of health;

or provided by a personal care provider licensed or regulated by any

other state or local agency; and such other services for which medical

assistance is otherwise available under this chapter which are

designated as long term care services in law or regulations of the

department of health.

2. Notwithstanding any inconsistent provision of this chapter or any

other law to the contrary, the partnership for long term care program

shall provide Medicaid extended coverage to a person receiving long term

care services if there is federal participation pursuant to such

treatment and such person: (a) is or was covered by an insurance policy

or certificate providing coverage for long term care which meets the

applicable minimum benefit standards of the superintendent of financial

services and other requirements for approval of participation under the

program; and, (b) has exhausted the coverage and benefits as required by

the program.

3. Notwithstanding any inconsistent provision of this chapter or any

other law to the contrary, the commissioner of health, in consultation

with the superintendent of financial services and the director of the

budget, may enter into reciprocal agreements with other states which

administer partnership for long term care programs under which

purchasers of policies in those states with comparable benefits to

policies available in this state shall be eligible for Medicaid extended

coverage in this state so long as purchasers of policies in this state

with comparable benefits to policies available in such state or states

shall be eligible for Medicaid extended coverage in such state or

states.