A 1907: Eliminates the "look-back period" for home care for non-institutionalized Medicaid applicants; repeals a certain provision of law relating thereto.
The bill aims to eliminate a "look-back period" for home care services for non-institutionalized Medicaid applicants. This means that individuals who have transferred assets for less than fair market value within the look-back period will no longer be ineligible for community-based long-term care services. The look-back period is currently defined as a 60-month period for institutionalized individuals and a 30-month period for non-institutionalized individuals. However, the bill will simplify the definition to a 60-month period for both institutionalized and non-institutionalized individuals. The bill will also allow for the review of eligibility for retroactive authorization of medical expenses incurred during the three months prior to the month of application for medical assistance.
| Jan. 07, 2026 | referred to health |
| Jan. 14, 2025 | referred to health |
STATE OF NEW YORK ________________________________________________________________________ 1907 2025-2026 Regular Sessions IN ASSEMBLY January 14, 2025 ___________ Introduced by M. of A. PAULIN, DAVILA -- read once and referred to the Committee on Health AN ACT to amend the social services law, in relation to eliminating a "look-back period" for home care for non-institutionalized Medicaid applicants; and repealing certain provisions of such law relating thereto The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Clause (xi) of subparagraph 1 of paragraph (e) of subdivi- 2 sion 5 of section 366 of the social services law is REPEALED. 3 § 2. The opening paragraph of subparagraph 3 of paragraph (e) of 4 subdivision 5 of section 366 of the social services law, as amended by 5 section 14 of part MM of chapter 56 of the laws of 2020, is amended to 6 read as follows: 7 In determining the medical assistance eligibility of an institutional- 8 ized individual, any transfer of an asset by the individual or the indi- 9 vidual's spouse for less than fair market value made within or after the 10 look-back period shall render the individual ineligible for nursing 11 facility services for the period of time specified in subparagraph five 12 of this paragraph. [In determining the medical assistance eligibility of13a non-institutionalized individual, any transfer of an asset by the14individual or the individual's spouse for less than fair market value15made within or after the look-back period shall render the individual16ineligible for community based long term care services for the period of17time specified in subparagraph five of this paragraph.] For purposes of 18 this paragraph: 19 § 3. Clause (vi) of subparagraph 1 of paragraph (e) of subdivision 5 20 of section 366 of the social services law, as amended by section 13 of 21 part MM of chapter 56 of the laws of 2020, is amended to read as 22 follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD05294-01-5A. 1907 2 1 (vi) "look-back period" means the sixty-month period immediately 2 preceding the date that an institutionalized individual is both institu- 3 tionalized and has applied for medical assistance[, or in the case of a4non-institutionalized individual, subject to federal approval, the thir-5ty-month period immediately preceding the date that such non-institu-6tionalized individual applies for medical assistance coverage of long7term care services. Nothing herein precludes a review of eligibility for8retroactive authorization for medical expenses incurred during the three9months prior to the month of application for medical assistance]. 10 § 4. This act shall take effect immediately.