BILL NUMBER: SB 483 CHAPTERED
BILL TEXT
CHAPTER 379
FILED WITH SECRETARY OF STATE SEPTEMBER 27, 2008
APPROVED BY GOVERNOR SEPTEMBER 27, 2008
PASSED THE SENATE AUGUST 21, 2008
PASSED THE ASSEMBLY AUGUST 12, 2008
AMENDED IN ASSEMBLY JUNE 18, 2008
AMENDED IN ASSEMBLY JUNE 2, 2008
AMENDED IN ASSEMBLY MAY 5, 2008
AMENDED IN ASSEMBLY JUNE 27, 2007
INTRODUCED BY Senator Kuehl
(Principal coauthor: Assembly Member Berg)
FEBRUARY 22, 2007
An act to amend Sections 14005, 14015, and 14018 of, to amend and
renumber Section 14002 of, and to add Sections 14006.01, 14006.15,
14006.41, 14009.6, 14009.7, 14015.1, and 14015.2 to, the Welfare and
Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 483, Kuehl. Medi-Cal: home and facility care.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, and
which provides health care services to qualified low-income
recipients. Existing law establishes various criteria for eligibility
for Medi-Cal benefits. The Medi-Cal program is partially governed
and funded by federal Medicaid provisions.
Under existing law, Medi-Cal benefits include nursing facility
services and home- and community-based services.
This bill would, to the extent required by federal law, require
any applicant for, or recipient of, Medi-Cal benefits who requests
medical assistance for home and facility care, as defined, to meet
the specific eligibility requirements for the receipt of medical
assistance for home and facility care set forth in these provisions.
The bill would require an individual, as a condition of
eligibility for medical assistance for home and facility care, to
disclose a description of any interest that the individual or his or
her spouse has in an annuity, as specified. The bill would also
require the state, as an operation of law, to become a remainder
beneficiary of certain annuities, as described, unless the individual
notifies the state in writing that he or she prohibits the state
from becoming a remainder beneficiary, as provided, and would require
the department to inform an individual and his or her spouse of this
fact at the time of the individual's application or redetermination
of Medi-Cal eligibility. The bill would also require that before any
penalties, as provided for in the bill, are imposed that may result
in a period of ineligibility for medical assistance for home and
facility care, an individual shall have the right to demonstrate that
a period of ineligibility would be an undue hardship, as defined. It
would require the state to provide notice to individuals requesting
medical assistance for home and facility care of the undue hardship
exception and would require a determination of whether an undue
hardship exists to be made before an applicant is denied eligibility
for medical assistance for home and facility care. If an individual
or his or her spouse notifies the state in writing that he or she
prohibits the state from becoming a remainder beneficiary to his or
her annuity, the bill would require the annuity to be treated as a
transfer of assets for less than fair market value for purposes of
determining Medi-Cal eligibility.
This bill would express the intent of the Legislative that its
provisions shall apply prospectively to any individual to whom the
bill applies commencing from the date regulations adopted pursuant to
this bill are filed with the Secretary of State.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14002 of the Welfare and Institutions Code, as
amended by Section 3 of Chapter 1024 of the Statutes of 1992, is
amended and renumbered to read:
14002.5. For the purposes of this article, the following
definitions shall apply:
(a) "Annuity" means a contract that names an annuitant and gives a
person or entity the right to receive periodic payments of a fixed
or variable sum for a described period of time, which may include a
lump-sum payment or periodic payments upon the death of the
annuitant.
(b) "Community spouse" means the spouse of an institutionalized
spouse.
(c) "Home and facility care" means the following services that are
subject to Medi-Cal reimbursement:
(1) Nursing facility care services.
(2) A level of care in any institution equivalent to that of
nursing facility care services.
(3) Home- or community-based care services furnished under a
waiver granted pursuant to subsection (c) or (d) of Section 1396n of
Title 42 of the United States Code.
(d) "Institutionalized spouse" means any individual to whom all of
the following apply:
(1) The individual is in a medical institution or nursing facility
or is a person who is receiving institutional or noninstitutional
services from an organization with a frail elderly demonstration
project waiver pursuant to Chapter 8.75 (commencing with Section
14590), and is likely to meet that requirement for at least 30
consecutive days.
(2) The individual is married to a spouse who is not in a medical
institution or nursing facility, or to a spouse who is not receiving
services from any organization with a frail elderly demonstration
project waiver pursuant to Chapter 8.75 (commencing with Section
14590).
(3) Except for purposes of Sections 14005.7, 14005.12, 14005.16,
and 14005.17, an individual who is admitted to a medical institution
or nursing facility on or after September 30, 1989, and who applies
for Medi-Cal benefits on or after January 1, 1990, or a Medi-Cal
recipient who is admitted to a medical institution or nursing
facility on or after January 1, 1990.
(e) "Medical institution" has the same meaning as defined in
Section 435.1010 of Title 42 of the Code of Federal Regulations.
(f) "Nursing facility" has the same meaning as defined in Section
1250 of the Health and Safety Code.
SEC. 2. Section 14005 of the Welfare and Institutions Code is
amended to read:
14005. (a) The health care benefits and services specified in
this chapter, to the extent that such services are neither provided
under any other federal or state law nor provided nor available under
other contractual or legal entitlements of the person, shall be
provided under this chapter to any person who is a resident of this
state and is made eligible by the provisions of this article. It is
the intent of the Legislature that a provider shall look to such
other contractual or legal entitlements for payment before submitting
a bill for payment under this chapter.
(b) Any applicant for, or recipient of, Medi-Cal benefits who
requests medical assistance for home and facility care shall meet the
specific eligibility requirements for the receipt of medical
assistance for home and facility care set forth in this chapter.
(c) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.), and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(d) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(e) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 3. Section 14006.01 is added to the Welfare and Institutions
Code, to read:
14006.01. (a) This section applies to any individual who is
residing in a continuing care retirement community, as defined in
paragraph (11) of subdivision (c) of Section 1771 of the Health and
Safety Code, pursuant to a continuing care contract, as defined in
paragraph (8) of subdivision (c) of Section 1771 of the Health and
Safety Code, or pursuant to a life care contract, as defined in
subdivision (l) of Section 1771 of the Health and Safety Code, that
collects an entrance fee from its residents upon admission.
(b) In determining an individual's eligibility for Medi-Cal
benefits, the individual's entrance fee shall be considered a
resource available to the individual if all of the following apply:
(1) The individual has the ability to use the entrance fee, or the
contract provides that the entrance fee may be used, to pay for care
if other resources or income of the individual are insufficient to
pay for care.
(2) The individual is eligible for a refund of any remaining
entrance fee when he or she dies or terminates his or her contract
with, and leaves, the continuing care retirement community.
(3) The entrance fee does not confer an ownership interest in the
continuing care retirement community.
(c) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.), and any regulations adopted pursuant to that act, and only
to the extent required by federal law, and only to the extent that
federal financial participation is available.
(d) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(e) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 4. Section 14006.15 is added to the Welfare and Institutions
Code, to read:
14006.15. (a) For the purposes of this section, "equity interest"
means the lesser of the following:
(1) The assessed value of the principal residence determined under
the most recent tax assessment, less any encumbrances of record.
(2) The appraised value of the principal residence determined by
a qualified real estate appraiser who has been retained by the
applicant or beneficiary, less any encumbrances of record.
(b) Notwithstanding subdivisions (b) and (c) of Section 14006,
and except as provided in subdivision (c), an individual is not
eligible for medical assistance for home and facility care if his or
her equity interest in the principal residence exceeds seven hundred
fifty thousand dollars ($750,000). No later than December 31, 2011,
and each year thereafter, this amount shall be increased based on the
percentage increase in the consumer price index for all urban
consumers (all items, United States city average), rounded to the
nearest one thousand dollars ($1,000).
(c) This section does not apply to an individual if any of the
following circumstances exist:
(1) The spouse of the individual or the individual's child, who is
under 21 years of age, or who is blind or who is disabled, as
defined in paragraph (3) of subsection (a) of Section 1382c of Title
42 of the United States Code, is lawfully residing in the individual'
s home.
(2) The individual was determined eligible for medical assistance
for home and facility care based on an application filed before
January 1, 2006.
(3) The department determines that ineligibility for medical
assistance for home and facility care would result in demonstrated
hardship on the individual. For purposes of this section,
demonstrated hardship shall include, but need not be limited to, any
of the following circumstances:
(A) The individual was receiving home and facility care prior to
January 1, 2006.
(B) The individual has been determined to be eligible for medical
assistance for home and facility care based on an application filed
on or after January 1, 2006, and before the date that regulations
adopted pursuant to this section are certified with the Secretary of
State.
(C) The individual purchased and received benefits under a
long-term care insurance policy certified by the department's
California Partnership for Long-Term Care Program, established by
Division 12 (commencing with Section 22000).
(D) The individual's equity interest in the principal residence
exceeds the equity interest limit as provided in subdivision (b), but
would not exceed the equity interest limit under that subdivision if
it had been increased by using the quarterly House Price Index (HPI)
for California, published by the Office of Federal Housing
Enterprise Oversight (OFHEO).
(E) The applicant or beneficiary has been denied a home equity
loan by at least three lending institutions, or is ineligible for any
one Federal Housing Administration (FHA) approved loan or reverse
mortgage.
(F) The applicant or beneficiary, with good cause, is unable to
provide verification of the equity value.
(G) The applicant or beneficiary meets the criteria set forth in
subdivision (b) of Section 14015.1.
(d) To the extent that federal financial participation is
unavailable to cover the costs associated with subparagraph (C) of
paragraph (3) of subdivision (c), state general funds shall be used.
(e) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and
except for subparagraph (C) of paragraph (3) of subdivision (c), and
subdivision (d), only to the extent that federal financial
participation is available.
(f) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(g) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 5. Section 14006.41 is added to the Welfare and Institutions
Code, to read:
14006.41. (a) To be eligible for medical assistance for home and
facility care, an individual shall disclose at the time of the
individual's application or redetermination a description of any
interest that he or she or his or her spouse has in an annuity, which
is known to the individual or his or her spouse, regardless of
whether the annuity is irrevocable or is treated as income or as a
resource.
(b) At the time of the individual's application or
redetermination, the department shall inform the individual and his
or her spouse that, by virtue of its provision of medical assistance
for home and facility care to the individual, the state will, by
operation of law, become a remainder beneficiary of certain
annuities, as described in Section 14009.6.
(c) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(d) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(e) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 6. Section 14009.6 is added to the Welfare and Institutions
Code, to read:
14009.6. (a) As a result of providing medical assistance for home
and facility care to an individual, the state shall, by operation of
law, become a remainder beneficiary, to the extent required by
Section 1917(e) of the federal Social Security Act (42 U.S.C. Sec.
1396p(e)), of annuities purchased in whole or in part by the
individual or his or her spouse in which the individual or his or her
spouse is an annuitant, except as provided in Section 14009.7,
unless the individual or his or her spouse notifies the department in
writing that he or she prohibits the state from acquiring a
remainder interest in his or her annuity, in which case subdivision
(d) shall apply.
(b) This section shall only apply to the following annuities:
(1) Those purchased on or after February 8, 2006.
(2) Those purchased before February 8, 2006, and subjected to a
transaction that occurred on or after February 8, 2006.
(A) For the purposes of this paragraph, "transaction" includes,
but is not limited to, any action taken by the individual or his or
her spouse that changes the course of payments to be made by the
annuity or the treatment of the income or principal of the annuity.
(B) For the purpose of this paragraph, "transaction" shall not
include any of the following:
(i) Routine changes and automatic events that do not require any
action or decision on or after February 8, 2006.
(ii) Changes that occur based on the terms of the annuity that
existed prior to February 8, 2006, and that do not require a
decision, election, or action to take effect.
(iii) Changes that are beyond the control of the individual or the
individual's spouse.
(c) Any provision in any annuity subject to this section that has
the effect of restricting the right of the state to become a
remainder beneficiary is void.
(d) If an individual or his or her spouse notifies the department
in writing that he or she prohibits the state from acquiring a
remainder interest in his or her annuity, the purchase of the annuity
shall be treated as the transfer of an asset for less than fair
market value that is subject to Section 14015.
(e) (1) When the state becomes aware of an annuity in which it has
acquired a remainder interest, the department shall notify the
issuer of the annuity of the state's acquisition of its remainder
beneficiary interest.
(2) The issuer of the annuity shall, upon notification by the
department, immediately inform the department of the amount of income
and principal being withdrawn from the annuity as of the date of the
individual's disclosure of the annuity.
(3) The issuer of the annuity shall, upon request by the
department or any agent of the department, immediately disclose to
the department the amount of income and principal being withdrawn
from the annuity.
(4) The issuer of the annuity shall immediately notify the
department if there is any change in either of the following:
(A) The amount of income or principal being withdrawn from that
annuity.
(B) The named beneficiaries of the annuity.
(f) Any moneys received by the state pursuant to this section
shall be deposited into the General Fund.
(g) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(h) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(i) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 7. Section 14009.7 is added to the Welfare and Institutions
Code, to read:
14009.7. (a) If an annuity is considered part or all of the
community spouse resource allowance allowed under subdivision (c) of
Section 14006, the state shall only become a remainder beneficiary of
that portion of the annuity that is not a part of that community
spouse resource allowance.
(b) The state shall not become a remainder beneficiary of an
annuity that is any of the following:
(1) Purchased by a community spouse with resources of the
community spouse during the continuous period in which the individual
is receiving medical assistance for home and facility care and after
the month in which the individual is determined eligible for these
benefits.
(2) Contained in a retirement plan qualified under Title 26 of the
United States Code, established by an employer or an individual,
including, but not limited to, an Individual Retirement Annuity or
Account (IRA), Roth IRA, or Keogh fund.
(3) An annuity that is all of the following:
(A) The annuity is irrevocable and nonassignable.
(B) The annuity is actuarially sound.
(C) The annuity provides for payments in equal amounts during the
term of the annuity, with no deferral and no balloon payments made
from the annuity.
(c) The individual or the community spouse, or both, shall bear
the burden of demonstrating that the requirements of this section
that limit the state's right to become a remainder beneficiary, as
described in Section 14009.6, are met.
(d) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(e) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(f) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 8. Section 14015 of the Welfare and Institutions Code is
amended to read:
14015. (a) (1) The providing of health care under this chapter
shall not impose any limitation or restriction upon the person's
right to sell, exchange or change the form of property holdings nor
shall the care provided constitute any encumbrance on the holdings.
However, the transfer or gift of assets, including income and
resources, for less than fair market value shall, pursuant to the
requirements of Title XIX of the federal Social Security Act (42
U.S.C. Sec. 1396 et seq.) and any regulations adopted pursuant to
that act, result in a period of ineligibility for medical assistance
for home and facility care, which may include partial months of
ineligibility, applied in accordance with federal law.
(2) Any items, including notes, loans, life estates, or annuities
that are held and distributed in a manner that is not in conformity
with the requirements of Title XIX of the federal Social Security Act
(42 U.S.C. Sec. 1396 et seq.) and regulations adopted pursuant to
that act, shall be treated as a transferred asset and may result in a
period of ineligibility as described in paragraph (1), as required
by Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act.
(b) Pursuant to Section 1917 (c)(2)(C)(ii) of the federal Social
Security Act (42 U.S.C. Sec. 1396p(c)(2)(C)(ii)), a satisfactory
showing that assets transferred exclusively for a purpose other than
to qualify for medical assistance shall not result in ineligibility
for Medi-Cal and shall include, but not be limited to, the following:
(1) Assets that would have been considered exempt for purposes of
establishing eligibility pursuant to federal or state laws at the
time of transfer.
(2) Property with a net market value that, when the property is
transferred, if included in the property reserve, would not result in
ineligibility.
(3) Assets for which adequate consideration is received.
(4) Property upon which foreclosure or repossession was imminent
at the time of transfer, provided there is no evidence of collusion.
(5) Assets transferred in return for an enforceable contract for
life care that does not include complete medical care.
(6) Assets transferred without adequate consideration, provided
that the applicant or beneficiary provides convincing evidence to
overcome the presumption that the transfer was for the purpose of
establishing eligibility or reducing the share of cost.
(c) In administering this section, it shall be presumed that
assets transferred by the applicant or beneficiary prior to the
look-back period established by the department preceding the date of
initial application were not transferred to establish eligibility or
reduce the share of cost. These assets shall not be considered in
determining eligibility.
(d) Any item of durable medical equipment which is purchased for a
recipient pursuant to this chapter exclusively with Medi-Cal program
funds shall be returned to the department when the department
determines that the item is no longer medically necessary for the
recipient. Items of durable medical equipment shall include, but are
not limited to, wheelchairs and special hospital beds.
(e) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(f) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(g) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 9. Section 14015.1 is added to the Welfare and Institutions
Code, to read:
14015.1. (a) The department shall consider, at initial
application or redetermination, whether an undue hardship, as
described in subdivision (b), exists prior to finding that an
applicant or recipient is subject to a period of ineligibility for
medical assistance for home and facility care pursuant to this
article. No person shall be subject to a period of ineligibility for
medical assistance for home and facility care at the time of the
initial application or redetermination if the department determines
that an undue hardship exists.
(b) An undue hardship shall be found to exist under any of the
following circumstances:
(1) The individual has been determined eligible for medical
assistance for home and facility care based on an application filed
on or after January 1, 2006, and before the date that regulations
adopted pursuant or relating to this section have been certified with
the Secretary of State.
(2) The deprivation of medical assistance for home and facility
care would cause an endangerment to the life or health of the
individual.
(3) The denial of medical assistance for home and facility care
would result in the eviction of the individual from a nursing home.
(4) The individual is otherwise eligible for the Medi-Cal program
and unable to obtain home and facility care without Medi-Cal.
(5) The denial of medical assistance for home and facility care
would cause the individual to be unable to remain at home or in the
community and would hasten or cause the individual's entry into a
medical or long-term care institution.
(6) The individual would be deprived of food, clothing, shelter,
or other necessities of life.
(c) The department shall establish regulations, procedures, and
forms that ensure all of the following:
(1) The department or county provides a notice of the undue
hardship process, at the initial request and the annual
redetermination, to any individual who requests medical assistance
for home and facility care. The notice shall inform the individual
that undue hardship shall be considered before a request for medical
assistance for home and facility care is denied.
(2) A timely and simplified process is established to determine
whether an undue hardship exists and an exception will be granted.
(3) If the issue of undue hardship is considered and found not to
apply, the department shall provide the individual with a notice of
action that states the reasons for the adverse determination. The
notice of action shall specify how that adverse determination can be
appealed. Upon the request of the applicant or beneficiary, or person
acting on his or her behalf, undue hardship notices shall be
provided to the home and facility care administrator in accordance
with regulations promulgated by the department.
(d) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(e) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(f) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 10. Section 14015.2 is added to the Welfare and Institutions
Code, to read:
14015.2. (a) In accordance with Section 1917(c)(2)(D) of the
federal Social Security Act (42 U.S.C. Sec. 1396p(c)(2)(D)), any of
the following may request a fair hearing on the issue of undue
hardship:
(1) An
individual requesting or receiving medical assistance for home and
facility care.
(2) A personal representative of an individual requesting or
receiving medical assistance for home and facility care.
(3) The facility in which the individual requesting or receiving
medical assistance for home and facility care is residing, with the
consent of that individual or the personal representative of that
individual.
(b) An individual with a pending undue hardship appeal who is
subject to a period of ineligibility pursuant to this article shall
receive medical assistance for home and facility care for a maximum
of 30 bed-hold days.
(c) This section does not alter or limit the right of applicants
or recipients to obtain a state hearing in accordance with Chapter 7
(commencing with Section 10950) of Part 2.
(d) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. 1396 et
seq.), and any regulations adopted pursuant to that act, and only to
the extent that federal financial participation is available.
(e) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(f) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.
SEC. 11. Section 14018 of the Welfare and Institutions Code is
amended to read:
14018. (a) (1) The Medi-Cal card shall be authorization for
payment for health care services rendered, during and subsequent to
the month of application of a person eligible under Section 14005.1,
or a person eligible under Section 14005.4 or 14005.7 who is
certified by the department.
(2) The Medi-Cal card shall be signed and dated in the space
provided on the card by the beneficiary upon receipt of the card and
prior to presentation of the card for any service. This paragraph
shall not apply to either of the following:
(A) Persons 17 years of age and under.
(B) Persons in long-term care.
(b) Notwithstanding subdivision (a), any person with a Medi-Cal
card who receives medical assistance for home and facility care may
be ineligible for payment for periods of time, including partial
months of ineligibility, as determined pursuant to Section 14015 and
in accordance with Title XIX of the federal Social Security Act (42
U.S.C. Sec. 1396 et seq.).
(c) This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396
et seq.) and any regulations adopted pursuant to that act, and only
to the extent that federal financial participation is available.
(d) To the extent that regulations are necessary to implement this
section, the department shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(e) It is the intent of the Legislature that the provisions of
this section shall apply prospectively to any individual to whom the
act applies commencing from the date regulations adopted pursuant to
this act are filed with the Secretary of State.