Relating to Medicaid-related programs and services including the work without worry program for employed individuals with disabilities and complex rehabilitation technology

This bill relates to programs and services under the Medicaid program. The bill creates the work without worry program for employed individuals with disabilities to years of age under the Medicaid program. The bill directs the department of health and human services (HHS) to submit any waiver request or state plan amendment, or combination thereof, to the centers for Medicare and Medicaid services of the United States department of health and human services as necessary to create a work without worry program for employed individuals with disabilities in accordance with the bill. Criteria for coverage under the program include that the individual has a qualifying disability and although an individual is not required to receive federal disability benefits to participate in the program, an individual who receives supplemental security income shall be automatically eligible for coverage under the program; the individual is to years of age; the individual is employed and has earned income from employment including self-employment; the individual is not subject to any resource or asset test or limit under the program with the exception of nonadapted vehicles and a primary residence for which the assessed value exceeds $400,000; the individual’s income is below 450 percent of the federal poverty level as adjusted by specified deductions or disregards; the individual has access to all traditional Medicaid services as well as additional long-term services and supports and community-based services subject to waiting lists and availability of openings; the individual may be eligible for or receive other coverage including through an employer, through Medicare, through the medically needy program, the qualified Medicare beneficiary program, or the specified low-income Medicare beneficiary program, and is not subject to otherwise applicable premiums if the individual is subject to copayments or premiums for the other coverage; the individual with income at or above 150 percent of the federal poverty level shall be subject to payment of a premium not to exceed the limits established under federal guidelines; and the program shall provide that any individual participating in the Medicaid for employed persons with disabilities program at the time the work without worry program is implemented shall be transferred to and enrolled in the work without worry program. The bill also requires HHS to implement a work without worry public awareness campaign to ensure that consumer information and educational resources are accessible to individuals with disabilities and the public, and to provide technical assistance to individuals with disabilities in determining if the work without worry program is the best option for coverage under the individual’s particular circumstances and in applying for and maintaining participation in the program. The bill also provides that under both Medicaid managed care and fee-for-service administration of the Medicaid program, HHS shall not require a prescription for reimbursement of a provider for the repair of complex rehabilitation technology, if the complex rehabilitation technology was previously prescribed and reimbursed under the Medicaid program. The bill defines complex rehabilitation technology.