HB 1115 Summary

• Amends North Dakota medical assistance (Medicaid) law to create new definitions for "department," "medical assistance," and "third party," and establishes procedures for Medicaid claims processing and provider criminal background checks.

• Requires criminal history record checks and fingerprinting for Medicaid service applicants, providers, staff members, and individuals with 5% or greater ownership interest; allows department to deny provider enrollment or terminate providers based on background investigation results.

• Modifies eligibility requirements and asset limitations for medical assistance recipients, including community spouse resource allowances, funeral pre-need contracts up to $6,000, and annuity transfer rules with specific requirements for purchases before and after February 8, 2006.

• Changes medical assistance provisions for dual Medicare-Medicaid eligible individuals to eliminate prior authorization and additional documentation requirements for durable medical equipment and supplies already paid by Medicare.

• Makes personal care services program mandatory (rather than optional) for basic care facilities and allows department to require Medicare-eligible individuals to apply for Medicare coverage as a condition of Medicaid eligibility.