SB1082 - 472R - House Bill Summary

House of Representatives

SB 1082

AHCCCS; member's estate; notification requirements

Sponsors: Representative Quelland, Senator Allen

X	Committee on Health
	Caucus and COW
	As Engrossed and As Passed the House

SB1082 requires notification of the death of certain members of the Arizona Health Care Cost Containment System (AHCCCS) within the three months following their death.

History

The Arizona Long-Term Care System (ALTCS) is Arizona’s Medicaid long-term care program, which is administered by AHCCCS. For ALTCS members age 55 and older, federal law requires AHCCCS to seek recovery from the member’s estate for payments for long-term care services, including related hospital and prescription drug services. For these individuals, AHCCCS will file a claim against the member’s estate for the total amount of long-term care system payments made on the member’s behalf, including capitation payments. AHCCCS waives or reduces its estate claim under certain “undue hardship” criteria. Examples of undue hardship include if the heir to the estate operates a business out of the home and would lose his or her livelihood, or if the heir is low-income and has limited or no assets. In addition, AHCCCS defers its claim if the member leaves a surviving spouse, child under age 21 or blind or disabled child. According to AHCCCS, the claim is deferred until the estate property is sold.

The recovered funds are used to pay the contractor for the costs of recovery. Of the monies remaining after paying the contractor, the corresponding federal share is returned to the federal government, pursuant to federal law, and the state share is retained by AHCCCS to offset the state costs of the program. AHCCCS reports that in FY 2004-2005, recoveries totaled $1.7 million, of which approximately $600,000 was the state’s share. AHCCCS estimates SB 1082 could increase the recoveries by $100,000 to $500,000 annually. Of this amount, approximately $35,000 to $175,000 would be the state’s share, which may reduce the state General Fund requirements for AHCCCS funding by a corresponding amount.

Provisions

· Requires that within three months of the member’s death an AHCCCS member’s personal representative must notify the administration of the member’s estate or property if:

· the member was at least 55 years of age.

· the administration has not already filed a claim in the estate proceedings.

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Forty-seventh Legislature