HS HCS HB 1566 -- MEDICAL ASSISTANCE BENEFITS (Stefanick)

This substitute states that persons made eligible for medical
assistance benefits pursuant to the federal Ticket to Work and
Work Incentives Improvement Act of 1999; needy persons who comply
with Title XIX, Public Law 89-97, 1965 amendments to the federal
Social Security Act (42 U.S.C. Section 301 et seq.); and persons
who participate in the program for health care for uninsured
children will only be eligible for these benefits if annual
appropriations are made.  Certain medical assistance benefits
will only be provided if annual appropriations are made.  The
substitute also makes technical corrections to references that
have become obsolete.

The substitute states that recipients of medical assistance who
meet the eligibility requirements for aid to families with
dependent children that were in effect on July 16, 1996, are
subject to an asset test of $1,000 for single parents and $2,000
for married parents.  Specified assets are excluded from this
asset test.  Under current law, there is a $250,000 net worth
asset test for families of children who participate in the
state's program to pay for health care for uninsured children.
The substitute changes the net worth test to a $25,000 asset test
and provides for the exclusion of specified assets.

The substitute requires the Department of Social Services to
conduct an annual income and eligibility verification review to
be completed no later than 12 months after the recipient's last
eligibility review determination.  It specifies how the
verification review may be completed and requires participants to
provide documentation for income verification.  The substitute
requires the department to establish by rule procedures for
requiring recipients or applicants to disclose certain
information about the availability of employer-sponsored health
care and the recipient or applicant's employment status at the
time of application or eligibility verification review.

The substitute requires the department to promulgate rules that
require recipients of medical assistance to participate in cost-
sharing activities, subject to the provisions of federal law.
The cost-sharing provisions do not apply to pharmaceuticals or to
in-home or home-health care services.  The substitute requires
providers to make reasonable efforts to collect copayments from
recipients and allows providers to make a claim to the Division
of Medical Services for any copayment that is not made by a
recipient.

Currently, parents and guardians of uninsured children with
available incomes between 186% and 225% of the federal poverty
level are responsible for a $5 copayment, and parents and
guardians of uninsured children with incomes between 226% and
300% of the federal poverty level are responsible for specified
copayments and premiums.  The substitute makes parents and
guardians of uninsured children with incomes between 151% and
300% of the federal poverty responsible for specified copayments
and premiums.

The substitute provides that for purposes of determining Medicaid
eligibility, investments in annuities must be actuarially sound,
provide for equal or nearly equal payments, and provide the State
of Missouri secondary or contingent beneficiary status.  The
department must establish a 36-month look-back period to review
investments in annuities made by applicants for Medicaid
benefits.

FISCAL NOTE:  Estimated Income on General Revenue Fund of $0 to
$771,076,401 in FY 2005, $0 to $807,825,955 in FY 2006, and $0 to
$843,005,816 in FY 2007.  Estimated Income on Other State Funds
of $5,800,000 in FY 2005, FY 2006, and FY 2007.

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:15 am