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This entry was published on 2014-09-22
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SECTION 367-F
Partnership for long term care program
Social Services (SOS) CHAPTER 55, ARTICLE 5, TITLE 11
§ 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.