Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.08-014 - State Plan Amendment #2007-019

Current through Register Vol. 49, No. 6, June, 2024
SUPPLEMENT 8c TO ATTACHMENT 2.6-A
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
STATE LONG-TERM CARE INSURANCE PARTNERSHIP
1902(r)(2) The following more liberal methodology applies to
				individuals who are eligible for
1917(b)(1)(C) medical assistance under one of the following
				eligibility groups:
Categorically needy individuals in nursing facilities and home
				& community based waiver programs under the special income level (300%)
				defined at 1902 (a)(10)(A)(ii)(V)."
An individual who is a beneficiary under a long-term care
				insurance policy that meets the requirements of a "qualified State long-term
				care insurance partnership" policy (partnership policy) as set forth below, is
				given a resource disregard as described in this amendment. The amount of the
				disregard is equal to the amount of the insurance benefit payments made to or
				on behalf of the individual. The term "long-term care insurance policy"
				includes a certificate issued under a group insurance contract.
X
The State Medicaid Agency (Agency)
				stipulates that the following requirements will be satisfied in order for a
				long-term care policy to qualify for a disregard. Where appropriate, the Agency
				relies on attestations by the State Insurance Commissioner (Commissioner) or
				other State official charged with regulation and oversight of insurance
				policies sold in the state, regarding information within the expertise of the
				State's Insurance Department.
STATE LONG-TERM CARE INSURANCE PARTNERSHIP
® The policy is a qualified long-term care insurance policy
				as defined in section 7702B(b) of the Internal Revenue Code of 1986.
® The policy meets the requirements of the long-term care
				insurance model regulation and long-term care insurance model Act promulgated
				by the National Association of Insurance Commissioners (as adopted as of
				October 2000) as those requirements are set forth in section 1917(b)(5)(A) of
				the Social Security Act.
* The policy was issued no earlier than the effective date of
				this State plan amendment.
® The insured individual was a resident of a Partnership
				State when coverage first became effective under the policy. If the policy is
				later exchanged for a different long-term care policy, the individual was a
				resident of a Partnership State when coverage under the earliest policy became
				effective.
* The policy meets the inflation protection requirements set
				forth in section 1917(b)(l)(C)(iii)(IV) of the Social Security Act.
® The Commissioner requires the issuer of the policy to
				make regular reports to the Secretary that include notification regarding when
				benefits provided under the policy have been paid and the amount of such
				benefits paid, notification regarding when the policy otherwise terminates, and
				such other information as the Secretary determines may be appropriate to the
				administration of such partnerships.
* The State does not impose any requirement affecting the terms
				or benefits of a partnership policy that the state does not also impose on
				non-partnership policies.
* The State Insurance Department assures that any individual
				who sells a partnership policy receives training, and demonstrates evidence of
				an understanding of such policies and how they relate to other public and
				private coverage of long-term care.
® The Agency provides information and technical assistance
				to the Insurance Department regarding the training described above.
(4) ____ The State disregards assets or
			 resources for individuals who receive or are entitled to receive benefits under
			 a long term care insurance policy as provided for in Attachment 2.6-A,
			 Supplement 8b.
____ The State adjusts or recovers from the individual's estate
				on account of all medical assistance paid for nursing facility and other long
				term care services provided on behalf of the individual. (States other than
				California, Connecticut, Indiana, Iowa, and New York which provide long term
				care insurance policy-based asset or resource disregard must select this entry.
				These five States may either check this entry or one of the following
				entries.)
____ The State does not adjust or recover from the individual's
				estate on account of any medical assistance paid for nursing facility or other
				long term care services provided on behalf of the individual.
____ The State adjusts or recovers from the assets or resources
				on account of medical assistance paid for nursing facility or other long term
				care services provided on behalf of the individual to the extent described
				below:
1917(b) 1 (C) __X If an individual covered under a long-term
				care insurance policy received benefits for which assets or resources were
				disregarded as provided for in Attachment 2.6-A, Supplement 8c (State Long-Term
				Care Insurance Partnership), the State does not seek adjustment or recovery
				from the individual's estate for the amount of assets or resources
				disregarded.