108A-70.4. Long-Term Care Partnership Program.
(a) The following definitions apply in this section:
(1) Asset. - Resources and income.
(2) Department. - The Department of Health and Human Services.
(3) Division. - The Division of Health Benefits.
(4) Estate recovery. - The placing of a statutory claim on the estate of a deceased Medicaid recipient, as provided by G.S. 108A-70.5.
(5) Medicaid. - The federal medical assistance program established under Title XIX of the Social Security Act.
(6) Qualified long-term care partnership policy or qualified policy. - A long-term care insurance policy approved for use in North Carolina and that meets all the requirements of the federal Deficit Reduction Act of 2005, P.L. 109-171.
(7) Resource. - Cash or its equivalent and real or personal property that is available to an applicant or recipient.
(8) Resource disregard. - The amount of resources of an applicant for long-term care Medicaid that is equal to the amount of benefits paid to the applicant under a qualified long-term care partnership policy.
(9) Resource protection. - An amount equal to the resource disregard given to a Medicaid recipient during the long-term care Medicaid eligibility determination process.
(b) There is established the North Carolina Long-Term Care Partnership Program (Partnership Program) to be administered by the Division with assistance from the Department of Insurance. The Partnership Program shall:
(1) Provide a mechanism for individuals to qualify for coverage of the cost of their long-term care needs under Medicaid without first being required to substantially exhaust their resources.
(2) Provide counseling services to individuals planning for their long-term care needs.
(3) Reduce the financial burden on the State medical assistance program by encouraging individuals to obtain private long-term care insurance.
(c) Under the Partnership Program, the Department shall:
(1) Provide resource disregard to an applicant for long-term care Medicaid who has received benefits under a qualified long-term care partnership policy. The amount of the resource disregard shall be equal to the total insurance benefits paid to the individual under a qualified policy after the implementation of the Partnership Program and prior to the individual's first application for long-term care Medicaid.
(2) Provide resource protection by reducing any subsequent recovery by the State under G.S. 108A-70.5 from a deceased recipient's estate for payment of Medicaid paid services by the amount of resource disregard given under subdivision (1) of this subsection.
(d) The Department shall adopt rules and amendments to the State Plan to allow for resource disregard at long-term care Medicaid eligibility determination and resource protection at estate recovery. The Department and the Department of Insurance shall adopt rules to implement the provisions of the Partnership Program and to provide for its administration.
(e) Effective January 1, 2011, or 60 days after approval of the Medicaid State Plan amendment, whichever is later, a qualified long-term care partnership policy shall be accompanied by a Partnership Disclosure Notice detailing in plain language the current law pertaining to the Partnership Program, resource disregard, and resource protection.
(f) The Department may enter into a reciprocal agreement with other states that enter into a national reciprocity agreement to extend the resource disregard and resource protection to residents of the State who purchased, or purchased and used, a qualified long-term care policy in another state.
(g) G.S. 108A-70.5 applies to the estate of an individual who received benefits under a qualified long-term care partnership policy. (2010-68, s. 1; 2019-81, s. 15(a).)
Structure North Carolina General Statutes
North Carolina General Statutes
Chapter 108A - Social Services
Article 2 - Programs of Public Assistance.
§ 108A-25 - Creation of programs; assumption by federally recognized tribe of programs.
§ 108A-25.1A - Responsibility for errors.
§ 108A-25.2 - Exemption from limitations for individuals convicted of certain drug-related felonies.
§ 108A-25.3 - Garnishment of wages to recoup fraudulent public assistance program payment.
§ 108A-26.5 - NC FAST caseworker training and certification program.
§ 108A-27.01 - Income eligibility and payment level for Work First Family Assistance.
§ 108A-27.1 - Time limitations on assistance.
§ 108A-27.2 - General duties of the Department.
§ 108A-27.3 - Electing Counties - Duties of county boards of commissioners.
§ 108A-27.4 - Electing Counties - County Plan.
§ 108A-27.5 - Electing Counties - Duties of the Department.
§ 108A-27.7 - Standard Program County Plan.
§ 108A-27.8 - Standard Program Counties - Duties of Department.
§ 108A-27.10 - Duties of the Director of the Budget/Governor.
§ 108A-27.11 - Work First Program funding.
§ 108A-27.12 - Maintenance of effort.
§ 108A-27.13 - Performance standards.
§ 108A-27.14 - Corrective action.
§ 108A-27.15 - Assistance not an entitlement; appeals.
§ 108A-29 - Priority for employment services.
§ 108A-29.1 - Drug screening and testing for Work First Program applicants and recipients.
§ 108A-31 - Application for assistance.
§ 108A-36 - Assistance not assignable; checks payable to decedents.
§ 108A-37 - Personal representative for mismanaged public assistance.
§ 108A-38 - Protective and vendor payments.
§ 108A-39 - Fraudulent misrepresentation.
§ 108A-41 - (Effective until contingency met see note) Eligibility.
§ 108A-42 - Determination of disability.
§ 108A-43 - Application procedure.
§ 108A-44 - State funds to counties.
§ 108A-46.1 - Transfer of assets for purposes of qualifying for State-county Special Assistance.
§ 108A-47 - Limitations on payments.
§ 108A-48 - State Foster Care Benefits Program.
§ 108A-49 - Foster care and adoption assistance payments.
§ 108A-49.1 - Foster care and adoption assistance payment rates.
§ 108A-50 - State benefits for certain adoptive children.
§ 108A-50.1 - Special Needs Adoptions Incentive Fund.
§ 108A-50.2 - Adoption Promotion Fund.
§ 108A-51 - Authorization for Food and Nutrition Services.
§ 108A-51.1 - Prohibition on certain waivers.
§ 108A-52 - Determination of eligibility.
§ 108A-53 - Fraudulent misrepresentation.
§ 108A-53.1 - Illegal possession or use of electronic food and nutrition benefits.
§ 108A-54.2 - (Effective until contingency met see note) Procedures for changing medical policy.
§ 108A-54.3A - Eligibility categories and income thresholds.
§ 108A-54.4 - Income disregard for federal cost-of-living adjustments.
§ 108A-54.5 - Maintenance of waivers for dependents of members of Armed Forces.
§ 108A-55.1 - Medicare enrollment required.
§ 108A-55.3 - Verification of State residency required for medical assistance.
§ 108A-55.4 - Insurers to provide certain information to Department of Health and Human Services.
§ 108A-55.5 - Eligibility monitoring for medical assistance.
§ 108A-56 - Acceptance of federal grants.
§ 108A-57.1 - Rules governing transfer of medical assistance benefits between counties.
§ 108A-58.2 - Waiver of transfer of assets penalty due to undue hardship.
§ 108A-60 - Protection of patient property.
§ 108A-62 - Therapeutic leave for medical assistance patients.
§ 108A-63 - Medical assistance provider fraud.
§ 108A-63.1 - Health care fraud subpoena to produce documents.
§ 108A-64 - Medical assistance recipient fraud.
§ 108A-64.1 - Incentives to counties to recover fraudulent Medicaid expenditures.
§ 108A-65 - Conflict of interest.
§ 108A-66.1 - Medicaid buy-in for workers with disabilities.
§ 108A-67 - Medicare/Qualified Disabled Working Individuals.
§ 108A-68 - Drug Use Review Program; rules.
§ 108A-68.1 - Certain prescription drugs exempt from prior authorization requirements.
§ 108A-69 - Employer obligations.
§ 108A-70 - Recoupment of amounts spent on medical care.
§ 108A-70.4 - Long-Term Care Partnership Program.
§ 108A-70.5 - Medicaid Estate Recovery Plan.
§ 108A-70.9A - (Effective until contingency met see note) Definitions; Medicaid recipient appeals.
§ 108A-70.9B - (Effective until contingency met see note) Contested Medicaid cases.
§ 108A-70.9C - Informal review permitted.
§ 108A-70.12 - Liability for certain acts; damages; effect of repayment.
§ 108A-70.13 - False claims procedure.
§ 108A-70.14 - Civil investigative demand.
§ 108A-70.15 - Employee remedies.
§ 108A-70.16 - Uniformity of interpretation.
§ 108A-70.37 - Timely decision standards.
§ 108A-70.38 - Timely processing standards.
§ 108A-70.39 - Average processing time standards.
§ 108A-70.40 - Percentage processed timely standards.
§ 108A-70.41 - Corrective action.
§ 108A-70.42 - Temporary assumption of Medicaid eligibility administration.
§ 108A-70.43 - (Effective until contingency met see note) Reporting.
§ 108A-70.46 - Audit of county Medicaid determinations.
§ 108A-70.47 - Medicaid eligibility determination processing accuracy standards.
§ 108A-70.48 - Quality assurance.
§ 108A-70.49 - Corrective action.
§ 108A-70.50 - Temporary assumption of Medicaid eligibility administration.
§ 108A-70.51 - (Effective until contingency met see note) Reporting.