FHJP Files Comment on Florida’s Request for 2 Year Extension of the State’s 1115 Managed Medical Assistance Waiver
Excerpt: "We strongly oppose the waiver of retroactive eligibility of Medicaid coverage for non-pregnant adults. Under federal Medicaid law, costs incurred during the three months prior to the month of application can be reimbursed if: 1) they are covered under the Florida Medicaid plan; and 2) the beneficiary would have been eligible for Medicaid at the time the expenses are incurred. The Legislative history related to this provision is highly relevant. Specifically, the three month retroactive period is meant to “protect persons who are eligible for Medicaid but do not apply for assistance until they have received care, either because they did not know about Medicaid eligibility requirements or because the sudden nature of their illness prevented their applying.” HR. Rep. 92-231 (1972) reprinted in 1972 U.S.C.C.A.N. 4089, 5099.
In other words, Congress responded to the simple fact that no one can predict sudden illness or accident. After someone is in a hospital or nursing facility, she or he may not be healthy enough to file a Medicaid application or may not understand that a Medicaid application should be filed.
Elimination of RME puts an unfair burden on elderly, ill, and disabled individuals and their families. Those who experience a catastrophic injury rendering them unable to apply quickly for Medicaid will be responsible for medical bills incurred during a period in which their bills are likely the highest. As a result, vulnerable low income Floridians are incurring crushing financial stress and debt."
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