Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1722.3 - BASIC HEALTH HAWAII
Subchapter 3 - SPECIAL BENEFIT PROVISIONS
Section 17-1722.3-28 - Long-term care provisions
Universal Citation: HI Admin Rules 17-1722.3-28
Current through August, 2024
(a) An individual age nineteen years or older receiving state medical assistance for long-term care services on the last day of the second month prior to the implementation date, shall:
(1) Be enrolled in a
participating health plan and receive state funded long-term care services,
either through a participating health plan or through a program that provides
benefits similar to a 1915(c) program; and
(2) Continue to receive the benefits as
described in (1) under the following conditions:
(A) The individual maintains continuous
categorical and financial eligibility as described under chapter 17-1719;
and
(B) The individual maintains
continuous eligibility for coverage of long-term care services.
(b) An individual under age nineteen years and receiving Medicaid for long-term care services in a nursing facility on the last day of the second month prior to the implementation date, if continuously receiving Medicaid for long-term care services until turning age nineteen years, shall upon turning age nineteen years:
(1) Be enrolled in a participating
health plan and receive state funded long-term care services; and
(2) Continue to receive the benefits as
described in paragraph (1) under the following conditions:
(A) The individual maintains continuous
categorical and financial eligibility as described under chapter 17-1719;
and
(B) The individual maintains
continuous eligibility for coverage of long-term care services.
(c) If an individual who is initially eligible under subsections (a) or (b) loses eligibility:
(1) On or before the transition period end
date, the individual shall be deemed into Basic Health Hawaii pursuant to
subchapter 4;
(2) After the
transition period end date, the individual shall be subject to the eligibility
and enrollment provisions described in subchapter 2.
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