NY State Senate Bill 2025-S4786

Senate Bill S4786

2025-2026 Legislative Session

Eliminates a look-back period for home care for non-institutionalized Medicaid applicants; and repeals a certain provision of the social services law relating thereto

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Current Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 12, 2025	referred to health

co-Sponsors

2025-S4786 (ACTIVE) - Details

See Assembly Version of this Bill:: A1907
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Rpld §366 sub 5 ¶(e) sub¶ 1 cl (xi), amd §366, Soc Serv L
Versions Introduced in 2023-2024 Legislative Session:: S6414, A9278

2025-S4786 (ACTIVE) - Summary

Eliminates the "look-back period" for home care for non-institutionalized Medicaid applicants; repeals a certain provision of law relating thereto.

2025-S4786 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4786

SPONSOR: SKOUFIS
 
TITLE OF BILL:

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 there-
to

 
PURPOSE:

To eliminate a look-back period for home care for home health care Medi-
caid applicants.

 
SUMMARY OF PROVISIONS:

Section 1: Repeals clause (xi) of subparagraph 1 of paragraph (e) of
subdivision 5 of section 366 of the social law.

Section 2: Amends the opening paragraph of subparagraph 3 of paragraph
(e) of subdivision 5 of section 366 of the social services law, to

remove the consideration of asset transfers for non-institutionalized
individuals for eligibility for community-based long-term care service.

Section 3: Amends clause (vi) of subparagraph 1 of paragraph (e) of
subdivision 5 of section 366 of the social services law, to remove the
30-month period for non-institutionalized individuals in the definition
of a look-back period.

Section 4: Sets Effective Date

 
JUSTIFICATION:

The SFY 2020-21 budget enacted a 30-month "lookback" period for home
health care Medicaid applicants. During a lookback period, the govern-
ment reviews an individual's financial transactions to determine whether
they have transferred assets for less than fair market value to qualify
for Medicaid coverage for long-term care.  Lookback periods had never
applied to home health care before the SFY 2020-21 budget provision, and
the change makes it more difficult for seniors to be eligible for Medi-
caid and home care.

Prior to the look-back period requirement, health care Medicaid approval
was much faster, which is vital for senior citizens and those with disa-
bilities since home care agencies cannot provide free care while appli-
cants wait extended periods for Medicaid approval.  Around-the-clock
home care can cost as much as a nursing home, which will push more
people into nursing homes where at least care will start immediately.
This bill will repeal the look-back period for home health care Medicaid
applicants so that older adults and people with disabilities will not
find themselves unnecessarily locked out of services that would protect
them in their homes and keep them safe from unnecessary institutionali-
zation.

 
LEGISLATIVE HISTORY:

Senate

2023: S6414, Referred to Health

2024: S6414, Advanced to Third Reading

Assembly

2023: N/A

2024: A9278, Referred to Health

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2025-S4786 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4786
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             February 12, 2025
                                ___________
 
 Introduced  by  Sens. SKOUFIS, CLEARE -- read twice and ordered printed,
   and when printed to be committed 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:
 
   Section 1. Clause (xi) of subparagraph 1 of paragraph (e) of  subdivi-
 sion 5 of section 366 of the social services law is REPEALED.
   §  2.  The  opening  paragraph  of  subparagraph 3 of paragraph (e) of
 subdivision 5 of section 366 of the social services law, as  amended  by
 section  14  of part MM of chapter 56 of the laws of 2020, is amended to
 read as follows:
   In determining the medical assistance eligibility of an institutional-
 ized individual, any transfer of an asset by the individual or the indi-
 vidual's spouse for less than fair market value made within or after the
 look-back period shall render  the  individual  ineligible  for  nursing
 facility  services for the period of time specified in subparagraph five
 of this paragraph. [In determining the medical assistance eligibility of
 a non-institutionalized individual, any transfer  of  an  asset  by  the
 individual  or  the  individual's spouse for less than fair market value
 made within or after the look-back period shall  render  the  individual
 ineligible for community based long term care services for the period of
 time  specified in subparagraph five of this paragraph.] For purposes of
 this paragraph:
   § 3. Clause (vi) of subparagraph 1 of paragraph (e) of  subdivision  5
 of  section  366 of the social services law, as amended by section 13 of
 part MM of chapter 56 of the  laws  of  2020,  is  amended  to  read  as
 follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05294-01-5
 S. 4786                             2

 
   (vi)  "look-back  period"  means  the  sixty-month  period immediately
 preceding the date that an institutionalized individual is both institu-
 tionalized and has applied for medical assistance[, or in the case of  a
 non-institutionalized individual, subject to federal approval, the thir-
 ty-month  period  immediately  preceding the date that such non-institu-
 tionalized individual applies for medical assistance  coverage  of  long
 term care services. Nothing herein precludes a review of eligibility for
 retroactive authorization for medical expenses incurred during the three
 months prior to the month of application for medical assistance].
   § 4. This act shall take effect immediately.

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Senate Bill S4786

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Sponsored By

James Skoufis