HOUSE BILL No. 4597

 

April 30, 2003, Introduced by Rep. Spade and referred to the Committee on Family and Children Services.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1939 PA 280, entitled                                             

                                                                                

    "The social welfare act,"                                                   

                                                                                

    by amending section 106 (MCL 400.106), as amended by 1990                   

                                                                                

    PA 145.                                                                     

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 106.  (1) A medically indigent individual is defined                   

                                                                                

2   as:                                                                         

                                                                                

3       (a) An individual receiving  aid to dependent children                      

                                                                                

4   family independence program benefits or an individual receiving             

                                                                                

5   supplemental security income under title XVI  of the social                 

                                                                                

6   security act, 42 U.S.C. 1381 to 1385,  or state supplementation             

                                                                                

7   thereunder  under title XVI subject to limitations imposed by              

                                                                                

8   the director  pursuant  according to title XIX.                             

                                                                                

9       (b) An individual  meeting  who meets all of the following                  

                                                                                

10  conditions:                                                                 

                                                                                


                                                                                

1                                                                                (i) The individual has  made application  applied in the                            

                                                                                

2   manner  prescribed by  the  state department  family independence           

                                                                                

3   agency prescribes.                                                          

                                                                                

4       (ii) The individual's need for the type of medical assistance                

                                                                                

5   available under this act for which  application has been made               

                                                                                

6   the individual applied has been professionally established and              

                                                                                

7   payment for it is not available through the legal obligation of a           

                                                                                

8   public or private contractor  , public or private,  to pay or               

                                                                                

9   provide for the care without regard to the income or resources of           

                                                                                

10  the patient.   The state department shall be subrogated to any              

                                                                                

11  right of recovery which a patient may have for the cost of                  

                                                                                

12  hospitalization, pharmaceutical services, physician services,               

                                                                                

13  nursing services, and other medical services not to exceed the              

                                                                                

14  amount of funds expended by the department for the care and                 

                                                                                

15  treatment of the patient.  The patient or other person acting in            

                                                                                

16  the patient's behalf shall execute and deliver an assignment of             

                                                                                

17  claim or other authorizations as necessary to secure the right of           

                                                                                

18  recovery to the department.  A payment may be withheld under this           

                                                                                

19  act for medical assistance for an injury or disability for which            

                                                                                

20  the patient is entitled to medical care or reimbursement for the            

                                                                                

21  cost of medical care under sections 3101 to 3179 of the insurance           

                                                                                

22  code of 1956, Act No. 218 of the Public Acts of 1956, as amended,           

                                                                                

23  being sections 500.3101 to 500.3179 of the Michigan Compiled                

                                                                                

24  Laws, or under any other policy of insurance providing medical or           

                                                                                

25  hospital benefits, or both, for the patient unless the patient's            

                                                                                

26  entitlement to that medical care or reimbursement is at issue.              

                                                                                

27  If a payment is made, the state department, to enforce its                  


                                                                                

1   subrogation right, may do either of the following:  (a) intervene           

                                                                                

2   or join in an action or proceeding brought by the injured,                  

                                                                                

3   diseased, or disabled person, the person's guardian, personal               

                                                                                

4   representative, estate, dependents, or survivors, against the               

                                                                                

5   third person who may be liable for the injury, disease, or                  

                                                                                

6   disability, or against contractors, public or private, who may be           

                                                                                

7   liable to pay or provide medical care and services rendered to an           

                                                                                

8   injured, diseased, or disabled patient; (b) institute and                   

                                                                                

9   prosecute a legal proceeding against a third person who may be              

                                                                                

10  liable for the injury, disease, or disability, or against                   

                                                                                

11  contractors, public or private, who may be liable to pay or                 

                                                                                

12  provide medical care and services rendered to an injured,                   

                                                                                

13  diseased, or disabled patient, in state or federal court, either            

                                                                                

14  alone or in conjunction with the injured, diseased, or disabled             

                                                                                

15  person, the person's guardian, personal representative, estate,             

                                                                                

16  dependents, or survivors.  The state department may institute the           

                                                                                

17  proceedings in its own name or in the name of the injured,                  

                                                                                

18  diseased, or disabled person, the person's guardian, personal               

                                                                                

19  representative, estate, dependents, or survivors.  As provided in           

                                                                                

20  section 6023 of the revised judicature act of 1961, Act No. 236             

                                                                                

21  of the Public Acts of 1961, as amended, being section 600.6023 of           

                                                                                

22  the Michigan Compiled Laws, the state department, in enforcing              

                                                                                

23  its subrogation right, shall not satisfy a judgment against the             

                                                                                

24  third person's property which is exempt from levy and sale.  The            

                                                                                

25  injured, diseased, or disabled person may proceed in his or her             

                                                                                

26  own name, collecting the costs without the necessity of joining             

                                                                                

27  the state department or the state as a named party.  The injured,           


                                                                                

1   diseased, or disabled person shall notify the state department of           

                                                                                

2   the action or proceeding entered into upon commencement of the              

                                                                                

3   action or proceeding.  An action taken by the state or the state            

                                                                                

4   department in connection with the right of recovery afforded by             

                                                                                

5   this section does not operate to deny the injured, diseased, or             

                                                                                

6   disabled person any part of the recovery beyond the costs                   

                                                                                

7   expended on the person's behalf by the state department.  The               

                                                                                

8   costs of legal action initiated by the state shall be paid by the           

                                                                                

9   state.  A payment shall not be made under this act for medical              

                                                                                

10  assistance for an injury, disease, or disability for which the              

                                                                                

11  patient is entitled to medical care or the cost of medical care             

                                                                                

12  under the worker's disability compensation act of 1969, Act                 

                                                                                

13  No. 317 of the Public Acts of 1969, as amended, being sections              

                                                                                

14  418.101 to 418.941 of the Michigan Compiled Laws; except that               

                                                                                

15  payment may be made if an appropriate application for medical               

                                                                                

16  care or the cost of the medical care has been made under Act                

                                                                                

17  No. 317 of the Public Acts of 1969, as amended, entitlement has             

                                                                                

18  not been finally determined, and an arrangement satisfactory to             

                                                                                

19  the state department has been made for reimbursement if the claim           

                                                                                

20  under Act No. 317 of the Public Acts of 1969, as amended, is                

                                                                                

21  finally sustained.                                                          

                                                                                

22      (iii) The individual has an annual income  which  that is                    

                                                                                

23  below, or because of medical expenses falls below, the protected            

                                                                                

24  basic maintenance level.  The protected basic maintenance level             

                                                                                

25  for 1-person and 2-person families shall be at least 100% of the            

                                                                                

26  higher of the payment standards generally used to determine                 

                                                                                

27  eligibility in the  aid to dependent children  family                       


                                                                                

1   independence program and the supplemental security income program           

                                                                                

2   under title XVI,  of the social security act, 42 U.S.C.  1381 to            

                                                                                

3   1385,  including state supplementation.  For families of 3 or               

                                                                                

4   more persons, the protected basic maintenance level shall be at             

                                                                                

5   least 100% of the payment standard generally used to determine              

                                                                                

6   eligibility in the  aid to dependent children  family                       

                                                                                

7   independence program.  These levels shall recognize regional                

                                                                                

8   variations and shall not exceed 133-1/3% of the payment standard            

                                                                                

9   generally used to determine eligibility in the  aid to dependent            

                                                                                

10  children  family independence program.                                      

                                                                                

11      (iv) The individual, if  an aid to dependent children  a                     

                                                                                

12  family independence program related individual and living alone,            

                                                                                

13  has liquid or marketable assets of not more than $1,500.00 in               

                                                                                

14  value, or, if a 2-person family, the family has liquid or                   

                                                                                

15  marketable assets of not more than $2,000.00 in value.  The                 

                                                                                

16  state department  family independence agency shall establish               

                                                                                

17  comparable liquid or marketable asset amounts for larger family             

                                                                                

18  groups.  Excluded in making the determination of the value of               

                                                                                

19  liquid or marketable assets are the values of:  the homestead;              

                                                                                

20  clothing; household effects; $1,000.00 of cash surrender value of           

                                                                                

21  life insurance, except that if the health of the insured  is such           

                                                                                

22  as to make  makes continuance of the insurance desirable, the               

                                                                                

23  entire cash surrender value of life insurance is  to be  excluded           

                                                                                

24  from consideration, up to the  maximums  maximum provided or                

                                                                                

25  allowed by federal regulations and in accordance with the rules             

                                                                                

26  of the  state department  family independence agency; the fair              

                                                                                

27  market value of tangible personal property used in earning                  


                                                                                

1   income; an amount paid as judgment or settlement for damages                

                                                                                

2   suffered as a result of exposure to agent orange, as defined in             

                                                                                

3   section 5701 of the public health code,  Act No. 368 of the                 

                                                                                

4   Public Acts of 1978, being section 333.5701 of the Michigan                 

                                                                                

5   Compiled Laws  1978 PA 368, MCL 333.5701; the amount a nursing              

                                                                                

6   home is required to pay an individual under section 21799c(4) of            

                                                                                

7   the public health code, 1978 PA 368, MCL 333.21799c; and a space            

                                                                                

8   or plot purchased for the purposes of burial for the person.  For           

                                                                                

9   individuals related to the title XVI program,  of the social                

                                                                                

10  security act, 42 U.S.C.  1381 to 1385,  the appropriate resource            

                                                                                

11  levels and property exemptions specified in title XVI shall be              

                                                                                

12  used.                                                                       

                                                                                

13      (v) The individual is not an inmate of a public institution                 

                                                                                

14  except as a patient in a medical institution.                               

                                                                                

15      (vi) The individual meets the eligibility standards for                      

                                                                                

16  supplemental security income under title XVI  of the social                 

                                                                                

17  security act, 42 U.S.C.  1381 to 1385,  or for state                        

                                                                                

18  supplementation under the act, subject to limitations imposed by            

                                                                                

19  the director  pursuant  according to title XIX; or meets the                

                                                                                

20  eligibility standards for  aid to dependent children  family                

                                                                                

21  independence program benefits, except for income or income and              

                                                                                

22  resources; or is a child from 18 to 21 years of age and his or              

                                                                                

23  her adult caretaker would be eligible for  aid to dependent                 

                                                                                

24  children  family independence program benefits except for age,              

                                                                                

25  income, or income and resources; or is a child under 21 years of            

                                                                                

26  age and is from a family whose income is below the basic                    

                                                                                

27  maintenance level.                                                          


                                                                                

1       (2) As used in this act:  , "medical"                                       

                                                                                

2       (a) "Medical institution" means a state licensed or approved                

                                                                                

3   hospital, nursing home, medical care facility, psychiatric                  

                                                                                

4   hospital, or other facility or identifiable unit  thereof  of a             

                                                                                

5   listed institution certified as meeting established standards for           

                                                                                

6   a nursing home or hospital in accordance with the laws of this              

                                                                                

7   state.                                                                      

                                                                                

8       (b) "Title II" means title II of the social security act,                   

                                                                                

9   chapter 531, 49 Stat. 620, 42 U.S.C. 401 to 405, 406 to 418, 420            

                                                                                

10  to 423, 424a to 426-1, and 427 to 434.                                      

                                                                                

11      (c) "Title XVI" means title XVI of the social security act,                 

                                                                                

12  chapter 531, 49 Stat. 620, 42 U.S.C. 1381 to 1382j and 1383 to              

                                                                                

13  1383f.                                                                      

                                                                                

14      (3) The department of community health is subrogated to a                   

                                                                                

15  right of recovery that a patient has for the cost of                        

                                                                                

16  hospitalization, pharmaceutical services, physician services,               

                                                                                

17  nursing services, and other medical services not to exceed the              

                                                                                

18  amount of money expended by the department of community health              

                                                                                

19  for the care and treatment of the patient.  The patient or other            

                                                                                

20  person acting in the patient's behalf shall execute and deliver             

                                                                                

21  an assignment of claim or other authorization necessary to secure           

                                                                                

22  the right of recovery to the department of community health.  A             

                                                                                

23  payment may be withheld under this act for medical assistance for           

                                                                                

24  an injury or disability for which the patient is entitled to                

                                                                                

25  medical care or reimbursement for the cost of medical care under            

                                                                                

26  sections 3101 to 3179 of the insurance code of 1956, 1956 PA 218,           

                                                                                

27  MCL 500.3101 to 500.3179, or under another policy of insurance              


                                                                                

1   providing medical or hospital benefits, or both, for the patient            

                                                                                

2   unless the patient's entitlement to that medical care or                    

                                                                                

3   reimbursement is at issue.  If a payment is made, the department            

                                                                                

4   of community health, to enforce its subrogation right, may do               

                                                                                

5   either of the following:                                                    

                                                                                

6       (a) Intervene or join in an action or proceeding brought by                 

                                                                                

7   the injured, diseased, or disabled person, or the person's                  

                                                                                

8   guardian, personal representative, estate, dependents, or                   

                                                                                

9   survivors, against the third person who may be liable for the               

                                                                                

10  injury, disease, or disability or against public or private                 

                                                                                

11  contractors who may be liable to pay or provide medical care and            

                                                                                

12  services rendered to an injured, diseased, or disabled patient.             

                                                                                

13      (b) Institute and prosecute a legal proceeding against a                    

                                                                                

14  third person who may be liable for the injury, disease, or                  

                                                                                

15  disability or against a public or private contractor who may be             

                                                                                

16  liable to pay or provide medical care and services rendered to an           

                                                                                

17  injured, diseased, or disabled patient, in state or federal                 

                                                                                

18  court, either alone or in conjunction with the injured, diseased,           

                                                                                

19  or disabled person or the person's guardian, personal                       

                                                                                

20  representative, estate, dependent, or survivor.                             

                                                                                

21      (4) In enforcing its subrogation right under subsection (3),                

                                                                                

22  the department of community health may institute the proceedings            

                                                                                

23  in its own name or in the name of the injured, diseased, or                 

                                                                                

24  disabled person or the person's guardian, personal                          

                                                                                

25  representative, estate, dependent, or survivor.  As provided in             

                                                                                

26  section 6023 of the revised judicature act of 1961, 1961 PA 236,            

                                                                                

27  MCL 600.6023, the department of community health, in enforcing              


                                                                                

1   its subrogation right, shall not satisfy a judgment against the             

                                                                                

2   third person's property that is exempt from levy and sale.                  

                                                                                

3       (5) The injured, diseased, or disabled person may proceed in                

                                                                                

4   his or her own name, collecting the costs without the necessity             

                                                                                

5   of joining the department of community health or the state as a             

                                                                                

6   named party.  The injured, diseased, or disabled person shall               

                                                                                

7   notify the department of community health of the action or                  

                                                                                

8   proceeding entered into upon commencement of the action or                  

                                                                                

9   proceeding.                                                                 

                                                                                

10      (6) An action taken by the state or the department of                       

                                                                                

11  community health in connection with the right of recovery                   

                                                                                

12  afforded by this section does not deny the injured, diseased, or            

                                                                                

13  disabled person a part of the recovery beyond the costs expended            

                                                                                

14  on the person's behalf by the department of community health.               

                                                                                

15  The costs of legal action initiated by the state shall be paid by           

                                                                                

16  the state.  A payment shall not be made under this act for                  

                                                                                

17  medical assistance for an injury, disease, or disability for                

                                                                                

18  which the patient is entitled to medical care or the cost of                

                                                                                

19  medical care under the worker's disability compensation act of              

                                                                                

20  1969, 1969 PA 317, MCL 418.101 to 418.941; except that payment              

                                                                                

21  may be made if an appropriate application for medical care or the           

                                                                                

22  cost of the medical care has been made under the worker's                   

                                                                                

23  disability compensation act of 1969, 1969 PA 317, MCL 418.101 to            

                                                                                

24  418.941, entitlement has not been finally determined, and an                

                                                                                

25  arrangement satisfactory to the department of community health              

                                                                                

26  has been made for reimbursement if the claim is finally                     

                                                                                

27  sustained.                                                                  


                                                                                

1       Enacting section 1.  This amendatory act does not take                      

                                                                                

2   effect unless Senate Bill No. ______ or House Bill No. 4331                 

                                                                                

3   (request no. 02832'03) of the 92nd Legislature is enacted into              

                                                                                

4   law.