HOUSE BILL No. 4289


     February 23, 1999, Introduced by Reps. Koetje and Voorhees and referred to the Committee on Family and Children Services.


        A bill to amend 1939 PA 280, entitled

   "The social welfare act,"

   by amending section 106 (MCL 400.106), as amended by 1990 PA

   145.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         Sec. 106.  (1) A medically indigent individual is defined

 2    as:

 3         (a) An individual receiving  aid to dependent children 

 4    FAMILY INDEPENDENCE ASSISTANCE or an individual receiving supple-

 5    mental security income under title XVI  of the social security

 6     act, 42 U.S.C. 1381 to 1385,  or state supplementation

 7     thereunder  UNDER TITLE XVI subject to limitations imposed by

 8    the director pursuant to title XIX.

 9         (b) An individual meeting all of the following conditions:




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 1         (i) The individual has made application in the manner

 2    prescribed by the  state  department.

 3         (ii) The individual's need for the type of medical assist-

 4    ance available under this act  for which application has been

 5     made  THAT HE OR SHE APPLIED FOR has been professionally estab-

 6    lished and payment for it is not available through the legal

 7    obligation of a PUBLIC OR PRIVATE contractor  , public or

 8     private,  to pay or provide for the care without regard to the

 9    income or resources of the patient.  The  state  department

10     shall be  IS subrogated to any right of recovery  which  THAT a

11    patient  may have  HAS for the cost of hospitalization, pharma-

12    ceutical services, physician services, nursing services, and

13    other medical services not to exceed the amount of funds expended

14    by the department for the care and treatment of the patient.  The

15    patient or other person acting in the patient's behalf shall exe-

16    cute and deliver an assignment of claim or other authorizations

17     as  necessary to secure the right of recovery to the

18    department.  A payment may be withheld under this act for medical

19    assistance for an injury or disability for which the patient is

20    entitled to medical care or reimbursement for the cost of medical

21    care under sections 3101 to 3179 of the insurance code of 1956,

22     Act No. 218 of the Public Acts of 1956, as amended, being sec-

23     tions 500.3101 to 500.3179 of the Michigan Compiled Laws  1956 PA

24    218, MCL 500.3101 TO 500.3179, or under any other policy of

25    insurance providing medical or hospital benefits, or both, for

26    the patient unless the patient's entitlement to that medical care

27    or reimbursement is at issue.  If a payment is made, the  state 



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 1    department, to enforce its subrogation right, may do either of

 2    the following:  (a) intervene or join in an action or proceeding

 3    brought by the injured, diseased, or disabled person  ,  OR the

 4    person's guardian, personal representative, estate, dependents,

 5    or survivors, against the third person who may be liable for the

 6    injury, disease, or disability, or against PUBLIC OR PRIVATE con-

 7    tractors  , public or private,  who may be liable to pay or pro-

 8    vide medical care and services rendered to an injured, diseased,

 9    or disabled patient; (b) institute and prosecute a legal proceed-

10    ing against a third person who may be liable for the injury, dis-

11    ease, or disability, or against PUBLIC OR PRIVATE contractors  ,

12     public or private,  who may be liable to pay or provide medical

13    care and services rendered to an injured, diseased, or disabled

14    patient, in state or federal court, either alone or in conjunc-

15    tion with the injured, diseased, or disabled person  ,  OR the

16    person's guardian, personal representative, estate, dependents,

17    or survivors.  The  state  department may institute the proceed-

18    ings in its own name or in the name of the injured, diseased, or

19    disabled person  ,  OR the person's guardian, personal represen-

20    tative, estate, dependents, or survivors.  As provided in section

21    6023 of the revised judicature act of 1961,  Act No. 236 of the

22     Public Acts of 1961, as amended, being section 600.6023 of the

23     Michigan Compiled Laws  1961 PA 236, MCL 600.6023, the  state 

24    department, in enforcing its subrogation right, shall not satisfy

25    a judgment against the third person's property  which  THAT is

26    exempt from levy and sale.  The injured, diseased, or disabled

27    person may proceed in his or her own name, collecting the costs



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 1    without the necessity of joining the  state  department or the

 2    state as a named party.  The injured, diseased, or disabled

 3    person shall notify the  state  department of the action or pro-

 4    ceeding entered into upon commencement of the action or

 5    proceeding.  An action taken by the state or the  state  depart-

 6    ment in connection with the right of recovery afforded by this

 7    section does not  operate to  deny the injured, diseased, or dis-

 8    abled person any part of the recovery beyond the costs expended

 9    on the person's behalf by the  state  department.  The costs of

10    legal action initiated by the state shall be paid by the state.

11    A payment shall not be made under this act for medical assistance

12    for an injury, disease, or disability for which the patient is

13    entitled to medical care or the cost of medical care under the

14    worker's disability compensation act of 1969,  Act No. 317 of the

15     Public Acts of 1969, as amended, being sections 418.101 to

16     418.941 of the Michigan Compiled Laws  1969 PA 317, MCL 418.101

17    TO 418.941; except that payment may be made if an appropriate

18    application for medical care or the cost of the medical care has

19    been made under  Act No. 317 of the Public Acts of 1969, as

20     amended  THE WORKER'S DISABILITY COMPENSATION ACT OF 1969, 1969

21    PA 317, MCL 418.101 TO 418.941, entitlement has not been finally

22    determined, and an arrangement satisfactory to the  state 

23    department has been made for reimbursement if the claim under

24     Act No. 317 of the Public Acts of 1969, as amended  THE WORKER'S

25    DISABILITY COMPENSATION ACT OF 1969, 1969 PA 317, MCL 418.101 TO

26    418.941, is finally sustained.





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 1         (iii) The individual has an annual income  which  THAT is

 2    below, or because of medical expenses falls below, the protected

 3    basic maintenance level.  The protected basic maintenance level

 4    for 1-person and 2-person families shall be at least 100% of the

 5    higher of the payment standards generally used to determine eli-

 6    gibility in the aid to dependent children program and the supple-

 7    mental security income program under title XVI,  of the social

 8     security act, 42 U.S.C.  1381 to 1385,  including state

 9    supplementation.  For families of 3 or more persons, the pro-

10    tected basic maintenance level shall be at least 100% of the pay-

11    ment standard generally used to determine eligibility in the aid

12    to dependent children program.  These levels shall recognize

13    regional variations and shall not exceed 133-1/3% of the payment

14    standard generally used to determine eligibility in the aid to

15    dependent children program.

16         (iv) The individual, if  an aid to dependent children  A

17    FAMILY INDEPENDENCE ASSISTANCE related individual,  and  living

18    alone, AND NOT A SENIOR CITIZEN, has liquid or marketable assets

19    of not more than $1,500.00 in value, or, if a 2-person family,

20    the family has liquid or marketable assets of not more than

21    $2,000.00 in value.  The  state  department shall establish com-

22    parable liquid or marketable asset amounts for larger family

23    groups.  THE INDIVIDUAL, IF A SENIOR CITIZEN, HAS LIQUID OR MAR-

24    KETABLE ASSETS OF NOT MORE THAN $15,000.00 IN VALUE.  AS USED IN

25    THIS SUBPARAGRAPH, "SENIOR CITIZEN" MEANS AN INDIVIDUAL WHO IS 65

26    YEARS OF AGE OR OLDER. Excluded in making the determination of

27    the value of liquid or marketable assets are the values of:  the



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 1    homestead; clothing; household effects; $1,000.00 of cash

 2    surrender value of life insurance, except that if the health of

 3    the insured  is such as to make continuance of  MAKES CONTINUING

 4    the insurance desirable, the entire cash surrender value of life

 5    insurance is  to be  excluded from consideration, up to the maxi-

 6    mums provided or allowed by federal regulations and in accordance

 7    with the rules of the  state  department; the fair market value

 8    of tangible personal property used in earning income; an amount

 9    paid as judgment or settlement for damages suffered as a result

10    of exposure to agent orange, as defined in section 5701 of the

11    public health code,  Act No. 368 of the Public Acts of 1978,

12     being section 333.5701 of the Michigan Compiled Laws  1978 PA

13    368, MCL 333.5701; and a space or plot purchased for the

14     purposes  PURPOSE of burial for the person.  For  individuals 

15    AN INDIVIDUAL related to the title XVI program,  of the social

16     security act, 42 U.S.C.  1381 to 1385,  the appropriate resource

17    levels and property exemptions specified in title XVI shall be

18    used.

19         (v) The individual is not an inmate of a public institution

20    except as a patient in a medical institution.

21         (vi) The individual meets the eligibility standards for sup-

22    plemental security income under title XVI,  of the social secur-

23     ity act, 42 U.S.C.  1381 to 1385,  or for state supplementation

24    under the act, subject to limitations imposed by the director

25    pursuant to title XIX; or meets the eligibility standards for aid

26    to dependent children, except for income or income and resources;

27    or is a child from 18 to 21 years of age and his or her adult



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 1    caretaker would be eligible for aid to dependent children except

 2    for age, income, or income and resources; or is a child under 21

 3    years of age and is from a family whose income is below the basic

 4    maintenance level.

 5         (2) As used in this act:  , "medical 

 6         (A) "MEDICAL institution" means a state licensed or approved

 7    hospital, nursing home, medical care facility, psychiatric hospi-

 8    tal, or other facility or identifiable unit  thereof  OF THE

 9    FACILITY certified as meeting established standards for a nursing

10    home or hospital in accordance with the laws of this state.

11         (B) "TITLE XVI" MEANS TITLE XVI OF THE SOCIAL SECURITY ACT,

12    CHAPTER 531, 49 STAT. 620, 42 U.S.C. 1381 TO 1383f.
































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