Bill Text: CA SB1124 | 2013-2014 | Regular Session | Enrolled
Bill Title: Medi-Cal: estate recovery.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2014-09-25 - In Senate. Consideration of Governor's veto pending. [SB1124 Detail]
Download: California-2013-SB1124-Enrolled.html
BILL NUMBER: SB 1124 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 26, 2014
PASSED THE ASSEMBLY AUGUST 25, 2014
AMENDED IN ASSEMBLY AUGUST 18, 2014
AMENDED IN SENATE MARCH 26, 2014
INTRODUCED BY Senator Hernandez
FEBRUARY 19, 2014
An act to amend Section 14009.5 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 1124, Hernandez. Medi-Cal: estate recovery.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services and
under which qualified low-income persons receive health care
benefits. The Medi-Cal program is, in part, governed and funded by
federal Medicaid provisions.
Existing law, with certain exceptions, requires the department to
claim against the estate of a decedent, or against any recipient of
the property of that decedent by distribution or survival, an amount
equal to the payments for Medi-Cal services received or the value of
the property received by any recipient from the decedent by
distribution or survival, whichever is less. Existing law provides
for certain exemptions that restrict the department from filing a
claim against a decedent's property, including when there is a
surviving spouse during his or her lifetime. Existing law requires
the department, however, to make a claim upon the death of the
surviving spouse, as prescribed. Existing law, which has been held
invalid by existing case law, provides that the exemptions shall only
apply to the proportionate share of the decedent's state or property
that passes to those recipients, by survival or distribution, who
qualify for the exemptions.
This bill would instead provide that the department shall make
these claims only in specified circumstances and would define health
care services for these purposes. The bill would delete the
proportionate share provision and would delete the requirement that
the department make a claim upon the death of the surviving spouse.
The bill would also require the department to provide a current or
former beneficiary, or his or her authorized representative, upon
request and free of charge, with the total amount of Medi-Cal
expenses that have been paid on his or her behalf that would be
recoverable under these provisions, as specified.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14009.5 of the Welfare and Institutions Code is
amended to read:
14009.5. (a) Notwithstanding any other provision of this chapter,
the department shall claim against the estate of the decedent, or
against any recipient of the property of that decedent by
distribution or survival an amount equal to the payments for the
health care services received or the value of the property received
by any recipient from the decedent by distribution or survival,
whichever is less, only in either of the following circumstances:
(1) Notwithstanding paragraph (2), against the real property of a
decedent who was an inpatient in a nursing facility in accordance
with Section 1396p(b)(1)(A) of Title 42 of the United States Code.
(2) (A) The decedent was 55 years of age or older when the
individual received health care services.
(B) The department shall not claim under this paragraph when there
is any of the following:
(i) A surviving spouse.
(ii) A surviving child who is under 21 years of age.
(iii) A surviving child who is blind or permanently and totally
disabled, within the meaning of Section 1614 of the federal Social
Security Act (42 U.S.C. Sec. 1382c).
(b) (1) The department shall waive its claim, in whole or in part,
if it determines that enforcement of the claim would result in
substantial hardship to other dependents, heirs, or survivors of the
individual against whose estate the claim exists.
(2) The department shall notify individuals of the waiver
provision and the opportunity for a hearing to establish that a
waiver should be granted.
(c) (1) The department shall provide a current or former
beneficiary, or his or her authorized representative designated under
Section 14014.5, upon request and free of charge, with the total
amount of Medi-Cal expenses that have been paid on behalf of that
beneficiary that would be recoverable under this section.
(2) The department shall permit a beneficiary to request the
information described in paragraph (1) via the Internet, by
telephone, by mail, in person, or through other commonly available
electronic means.
(3) The department shall conspicuously post on its Internet Web
site, a description of the methods by which a request under this
subdivision may be made, including, but not limited to, the
department's telephone number and any addresses that may be used for
this purpose. The department shall also include this information in
its pamphlet for the Medi-Cal Estate Recovery Program and any other
notices the department distributes to beneficiaries regarding estate
recovery.
(d) The following definitions shall govern the construction of
this section:
(1) "Decedent" means a beneficiary who has received health care
under this chapter or Chapter 8 (commencing with Section 14200) and
who has died leaving property to others either through distribution
or survival.
(2) "Dependents" includes, but is not limited to, immediate family
or blood relatives of the decedent.
(3) "Health care services" means only those services required to
be recovered under Section 1396p(b)(1)(B)(i) of Title 42 of the
United States Code.
(e) The amendments made to this section by the act that added this
subdivision apply only to individuals who die on or after January 1,
2015.
