Nevada SB 64: Revises provisions governing the recovery of certain benefits paid under Medicaid. (BDR 38-479)

Bill Text

S.B. 64
- *SB64*

SENATE BILL NO. 64–COMMITTEE ON
HEALTH AND HUMAN SERVICES

(ON BEHALF OF THE STATE TREASURER)

PREFILED NOVEMBER 20, 2024
____________

Referred to Committee on Health and Human Services

SUMMARY—Revises provisions governing the recovery of certain
benefits paid under Medicaid. (BDR 38-479)

FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

AN ACT relating to Medicaid; prohibiting the State Government
from the recovery of Medicaid benefits from an account
established under the Nevada ABLE Savings Program in
certain circumstances; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing federal law allows for the creation of a tax-advantaged savings account 1
for a person who has certain qualifying disabilities, which is commonly known as 2
an ABLE Account. Under the program, any person may make a contribution to the 3
ABLE Account of a person with a qualified disability. Any interest or other growth 4
in the value of the ABLE Account is not taxed, and any distribution from the ABLE 5
Account is not taxed if the distribution is used to pay expenses related to living a 6
life with a disability, including, without limitation, education, housing, 7
transportation, health care, employment training and support, and assistive 8
technology and personal support services. Money in an ABLE Account or 9
distributions from an ABLE Account do not affect the eligibility of a person for 10
certain public benefits such as Social Security disability payments, Supplemental 11
Nutrition Assistance Program benefits and Medicaid. To qualify for these 12
advantages of an ABLE Account, the savings account into which contributions are 13
made on behalf of a qualified person must be established and maintained by the 14
qualified person’s state of residence or another state that has adopted a qualified 15
program and entered into a contract with the qualified person’s state of residence. 16
(26 U.S.C. § 529A) Existing state law requires the State Treasurer, in cooperation 17
with the Aging and Disability Services Division of the Department of Health and 18
Human Services, to establish or otherwise ensure the establishment of the Nevada 19

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- *SB64*
ABLE Savings Program as a qualified program under federal law. (NRS 20
427A.882-427A.896) 21
Existing federal and state law provide that under certain circumstances, the 22
Department is required to recover benefits correctly paid under Medicaid from the 23
estate of a deceased person who received those benefits or any recipient of money 24
or property from the estate of such a deceased person. (42 U.S.C. § 1396p; NRS 25
422.29302) Under existing federal law, upon the death of the designated 26
beneficiary of an ABLE Account, a state is authorized to file a claim for payment 27
from the ABLE Account to recover benefits paid under Medicaid on behalf of the 28
designated beneficiary that are recoverable by the state. (26 U.S.C. § 529A(f)) 29
Sections 1 and 3 of this bill provide that unless federal law otherwise requires, 30
the Department or any other officer or agency of State Government is prohibited 31
from seeking to recover benefits correctly paid under Medicaid for a designated 32
beneficiary of an ABLE Account: (1) from any money remaining in the ABLE 33
Account upon the death of the designated beneficiary; or (2) by filing a claim for 34
recovery from the ABLE Account. Section 1 additionally requires the Director of 35
the Department to apply for any necessary federal approval to carry out these 36
provisions. Section 2 of this bill authorizes the Director to administer the 37
provisions of section 1 in the same manner that the Director administers existing 38
law governing the recovery of benefits paid under Medicaid. 39
Section 4 of this bill provides that upon the passage and approval of this bill, 40
the Department and any other officer or agency of the State Government are 41
required to terminate any attempt to recover Medicaid benefits from an ABLE 42
Account, unless recovery from an ABLE Account is required by federal law. 43

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 422 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. Except to the extent required by federal law, upon the 3
death of a designated beneficiary of a savings trust account 4
established under the Nevada ABLE Savings Program pursuant to 5
NRS 427A.889, the Department or any other officer or agency of 6
the State Government shall not: 7
(a) Seek recovery under NRS 422.29302 of any amount 8
remaining in the savings trust account for any benefits that were 9
correctly paid under Medicaid after the savings trust account was 10
established; or 11
(b) File a claim for payment from the savings trust account 12
pursu