| HOUSE AMENDED |
| PRIOR PRINTER'S NO. 32 | PRINTER'S NO. 1461 |
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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY ROBBINS, MELLOW AND LOGAN, JANUARY 20, 2009 |
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| AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES, OCTOBER 3, 2009 |
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| AN ACT |
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1 | Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An |
2 | act to consolidate, editorially revise, and codify the public |
3 | welfare laws of the Commonwealth," in general powers and | <-- |
4 | duties of the Department of Public Welfare, providing for |
5 | determining whether applicants are veterans; in public |
6 | assistance, further providing for establishment of county |
7 | boards and expenses, for lifetime limit AND for prohibited | <-- |
8 | use of public assistance funds; further defining "exempt |
9 | hospital" and "general acute care hospital"; further |
10 | providing for authorization, for administration, for no hold |
11 | harmless, for tax exemption and for cessation; and providing |
12 | for fraud reporting to Inspector General. |
13 | The General Assembly of the Commonwealth of Pennsylvania |
14 | hereby enacts as follows: |
15 | Section 1. Section 415 of the act of June 13, 1967 (P.L.31, | <-- |
16 | No.21), known as the Public Welfare Code, is amended to read: |
17 | Section 1. The act of June 13, 1967 (P.L.31, No.21), known | <-- |
18 | as the Public Welfare Code, is amended by adding a section to |
19 | read: |
20 | Section 215. Determining Whether Applicants are Veterans.-- |
21 | (a) The department shall make a good faith effort to determine |
22 | whether an applicant for cash, medical or energy assistance is a |
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1 | veteran. While in the process of making its determination, the |
2 | department shall dispense benefits to the applicant, if |
3 | otherwise eligible. |
4 | (b) As a condition of eligibility to receive cash, medical |
5 | or energy assistance, unless there is good cause not to do so, |
6 | an applicant who is a veteran shall be required to contact a |
7 | veteran service officer accredited and recognized by the United |
8 | States Department of Veterans Affairs, the Department of |
9 | Military and Veterans Affairs or the county director of veterans |
10 | affairs in which the applicant resides in order to determine the |
11 | applicant's eligibility for veteran's benefits or to file a |
12 | veteran claims packet. The department shall develop a standard |
13 | form to be used by a veteran service officer to verify the |
14 | applicant's eligibility for veteran's benefits. |
15 | (c) An applicant who is a veteran shall provide proof of |
16 | compliance with this section and the department shall, to the |
17 | greatest extent possible, require the applicant to provide |
18 | information on the final determination of eligibility for |
19 | veteran's benefits and the type of benefits the veteran is |
20 | entitled to receive. |
21 | (d) As used in this section, the following words and phrases |
22 | shall have the following meanings: |
23 | "Assistance" means money, services and payment for medical |
24 | coverage or energy assistance for needy persons who are |
25 | residents of this Commonwealth, are in need of assistance and |
26 | meet all conditions of eligibility. |
27 | "Veteran claims packet" means an application requesting a |
28 | determination or entitlement or evidencing a belief in |
29 | entitlement to a benefit as provided for in 38 CFR (relating to |
30 | pensions, bonuses, and veterans' relief) or 51 Pa.C.S. (relating |
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1 | to military affairs). |
2 | Section 2. Section 415 of the act is amended to read: |
3 | Section 415. Establishment of County Boards; Expenses.--For |
4 | each county of the Commonwealth, there is hereby established a |
5 | county board of assistance, to be known as the County Board of |
6 | Assistance and referred to in this Article IV as the "county |
7 | board," which shall be composed of men and women, to be |
8 | appointed by the Governor [with the advice and consent of two- |
9 | thirds of all members of the Senate]. Each appointment by the |
10 | Governor shall bear the endorsement of the senator of the |
11 | district in which the nominee resides. In the case of a vacancy |
12 | in that senatorial district, the nominee shall be endorsed by |
13 | the senator of an adjacent district. The county boards shall be |
14 | composed as far as possible of persons engaged or interested in |
15 | business, social welfare, labor, industry, education or public |
16 | administration. The members of the county boards shall serve |
17 | without compensation, but shall be reimbursed for necessary |
18 | expenses. No member of a county board shall hold office in any |
19 | political party. Not all of the members of a county board shall |
20 | belong to the same political party. |
21 | Section 3. Section 441.4 of the act, added July 7, 2005 | <-- |
22 | (P.L.177, No.42), is amended to read: |
23 | Section 441.4. [Lifetime Limit] Reasonable Limits on |
24 | Allowable Income Deductions for Medical Expenses When |
25 | Determining Payment Toward the Cost of Long-Term Care |
26 | Services.--(a) [Necessary medical or remedial care expenses |
27 | recognized under Federal or State law but not paid for by the |
28 | medical assistance program are allowable income deductions when |
29 | determining a recipient's payment toward the cost of long-term |
30 | care services. An allowable income deduction for unpaid medical |
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1 | expenses incurred prior to the authorization of medical |
2 | assistance eligibility and those medical expenses incurred for |
3 | long-term care services after medical assistance is authorized |
4 | shall be subject to a lifetime maximum of ten thousand dollars |
5 | ($10,000) unless application of the limit would result in undue |
6 | hardship.] When determining a recipient's payment toward the |
7 | cost of long-term care services, long-term care medical expenses |
8 | incurred six months or more prior to application for medical |
9 | assistance shall be disallowed as a deduction, and medical and |
10 | remedial expenses that were incurred as a result of a transfer |
11 | of assets penalty shall be limited to zero unless application of |
12 | these limits would result in undue hardship. |
13 | (b) As used in this section, the term "undue hardship" shall |
14 | mean that either: |
15 | (1) denial of medical assistance would deprive the |
16 | individual of medical care and endanger the individual's health |
17 | or life; or |
18 | (2) the individual or a financially dependent family member |
19 | would be deprived of food, shelter or the necessities of life. |
20 | Section 4. The act is amended by adding a section to read: |
21 | Section 484. Prohibited Use of Public Assistance Funds.--It |
22 | shall be unlawful for any individual to purchase liquor or |
23 | alcohol with a gift certificate or a gift card which is in the |
24 | form of an electronic benefits card issued to convey public |
25 | assistance benefits administered by the Department of Public |
26 | Welfare or a debit card issued to convey support payment moneys. |
27 | Section 5. The definitions of "exempt hospital" and "general |
28 | acute care hospital" in section 801-E of the act, added July 4, |
29 | 2008 (P.L.557, No.44), are amended and the section is amended by |
30 | adding a definition to read: |
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1 | Section 801-E. Definitions. |
2 | The following words and phrases when used in this article |
3 | shall have the meanings given to them in this section unless the |
4 | context clearly indicates otherwise: |
5 | * * * |
6 | ["Exempt hospital." A hospital that the Secretary of Public |
7 | Welfare has determined meets one of the following: |
8 | (1) Is excluded under 42 CFR 412.23(a), (b), (d) and (f) |
9 | (relating to excluded hospitals: classifications) as of March |
10 | 20, 2008, from reimbursement of certain Federal funds under the |
11 | prospective payment system described by 42 CFR Pt. 412 (relating |
12 | to prospective payment systems for inpatient hospital services). |
13 | (2) Is a Federal veterans' affairs hospital. |
14 | (3) Is part of an institution with State-related status as |
15 | that term is defined in 22 Pa. Code § 31.2 (relating to |
16 | definitions) and provides over 100,000 days of care to medical |
17 | assistance patients annually. |
18 | (4) Provides care, including inpatient hospital services, to |
19 | all patients free of charge.] |
20 | "General acute care hospital." A hospital other than [an |
21 | exempt hospital.] a hospital that the Secretary of Public |
22 | Welfare has determined meets one of the following: |
23 | (1) Is excluded under 42 CFR 412.23(a), (b), (d), (e) and |
24 | (f) (relating to excluded hospitals: Classifications) as of |
25 | March 20, 2008, from reimbursement of certain Federal funds |
26 | under the prospective payment system described by 42 CFR 412 |
27 | (relating to prospective payment systems for inpatient hospital |
28 | services). |
29 | (2) Is a Federal veterans' affairs hospital. |
30 | (3) Is a high volume Medicaid hospital. |
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1 | (4) Provides care, including inpatient hospital services, to |
2 | all patients free of charge. |
3 | "High volume Medicaid hospital." A hospital that the |
4 | Secretary of Public Welfare has determined meets all of the |
5 | following: |
6 | (1) Is a nonprofit hospital subsidiary of a State-related |
7 | institution as that term is defined in 62 Pa.C.S. § 103 |
8 | (relating to definitions); and |
9 | (2) Provides more than 90,000 days of care to medical |
10 | assistance patients annually. |
11 | * * * |
12 | Section 6. Sections 802-E, 804-E, 805-E, 807-E and 808-E of |
13 | the act, added July 4, 2008 (P.L.557, No.44), are amended to |
14 | read: |
15 | Section 802-E. Authorization. |
16 | (a) General rule.--In order to generate additional revenues |
17 | for the purpose of assuring that medical assistance recipients |
18 | have access to hospital services and that all citizens have |
19 | access to emergency department services, and subject to the |
20 | conditions and requirements specified under this article, a |
21 | municipality may, by ordinance, [impose] do the following: |
22 | (1) Impose a monetary assessment on the net operating |
23 | revenue reduced by all revenues received from Medicare of each |
24 | general acute care hospital located in the municipality [subject |
25 | to the conditions and requirements specified under this |
26 | article]. |
27 | (2) Beginning on or after July 1, 2009, and subject to the |
28 | advance written approval by the secretary, impose a monetary |
29 | assessment on the net operating revenues reduced by all revenues |
30 | received from Medicare of each high volume Medicaid hospital |
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1 | located in the municipality. |
2 | (b) Administrative provisions.--The [ordinance] ordinances |
3 | adopted pursuant to subsection (a) may include appropriate |
4 | administrative provisions including, without limitation, |
5 | provisions for the collection of interest and penalties. |
6 | (c) Maximum assessment.--In each year in which the |
7 | assessment is implemented, the assessment shall be subject to |
8 | the maximum aggregate amount that may be assessed under 42 CFR |
9 | 433.68(f)(3)(i) (relating to permissible health care-related |
10 | taxes) or any other maximum established under Federal law. |
11 | Section 804-E. Administration. |
12 | (a) Remittance.--Upon collection of the funds generated by |
13 | the assessment authorized under this article, the municipality |
14 | shall remit a portion of the funds to the Commonwealth for the |
15 | purposes set forth under section 802-E, except that the |
16 | municipality may retain funds in an amount necessary to |
17 | reimburse it for its reasonable costs in the administration and |
18 | collection of the assessment and to fund a portion of its costs |
19 | of operating public health clinics as set forth in an agreement |
20 | to be entered into between the municipality and the Commonwealth |
21 | acting through the secretary. |
22 | (b) Establishment.--There is established a restricted |
23 | account in the General Fund for the receipt and deposit of funds |
24 | under subsection (a). Funds in the account are hereby |
25 | appropriated to the department for purposes of making |
26 | supplemental or increased medical assistance payments for |
27 | emergency department services to general acute care hospitals |
28 | within the municipality and to maintain or increase other |
29 | medical assistance payments to hospitals within the |
30 | municipality, as specified in the Commonwealth's approved Title |
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1 | XIX State Plan. |
2 | Section 805-E. No hold harmless. |
3 | No general acute care hospital or high volume Medicaid |
4 | hospital shall be directly guaranteed a repayment of its |
5 | assessment in derogation of 42 CFR 433.68(f) (relating to |
6 | permissible health care-related taxes), except that, in each |
7 | fiscal year in which an assessment is implemented, the |
8 | department shall use a portion of the funds received under |
9 | section 804-E(a) for the purposes outlined under section 804- |
10 | E(b) to the extent permissible under Federal and State law or |
11 | regulation and without creating an indirect guarantee to hold |
12 | harmless, as those terms are used under 42 CFR 433.68(f)(i). The |
13 | secretary shall submit any State Medicaid plan amendments to the |
14 | United States Department of Health and Human Services that are |
15 | necessary to make the payments authorized under section 804- |
16 | E(b). |
17 | Section 807-E. Tax exemption. |
18 | Notwithstanding any exemptions granted by any other Federal, |
19 | State or local tax or other law, including section 204(a)(3) of |
20 | the act of May 22, 1933 (P.L.853, No.155), known as The General |
21 | County Assessment Law, no general acute care hospital or high |
22 | volume Medicaid hospital in the municipality shall be exempt |
23 | from the assessment. |
24 | Section 808-E. [Cessation] Time period. |
25 | (a) Cessation.--The assessment authorized under this article |
26 | shall cease June 30, 2013. |
27 | (b) Assessment.--A municipality shall have the power to |
28 | enact the assessment authorized in section 802-E(a)(2) either |
29 | prior to or during its fiscal year ending June 30, 2010. |
30 | Section 7. The act is amended by adding a section to read: |
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1 | Section 1417. Fraud Reporting to Inspector General.--(a) If |
2 | an employe of a county assistance office who has reason to |
3 | believe a recipient or applicant of public assistance is |
4 | committing fraud or providing false information in order to |
5 | receive public assistance benefits, including, but not limited |
6 | to, medical assistance, cash assistance and food stamps, the |
7 | county assistance office employe shall make a fraud report |
8 | directly to the Office of Inspector General. |
9 | (b) The county assistance employe shall not be subject to |
10 | any sanctions for making a fraud report. |
11 | Section 2 8. This act shall take effect immediately. | <-- |
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