2021 Pennsylvania Consolidated & Unconsolidated Statutes
Act 69 - TOBACCO SETTLEMENT ACT - DEFINITIONS, MEDICAL ASSISTANCE BENEFITS FOR WORKERS WITH DISABILITIES AND WORKERS WITH MEDICALLY IMPROVED DISABILITIES
Session of 2021
No. 2021-69
SB 156
AN ACT
Amending the act of June 26, 2001 (P.L.755, No.77), entitled "An act establishing a special fund and account for money received by the Commonwealth from the Master Settlement Agreement with tobacco manufacturers; providing for home and community-based care, for tobacco use prevention and cessation efforts, for Commonwealth universal research enhancement, for hospital uncompensated care, for health investment insurance, for medical assistance for workers with disabilities, for regional biotechnology research centers, for the HealthLink Program, for community-based health care assistance programs, for PACE reinstatement and PACENET expansion, for medical education loan assistance and for percentage allocation and appropriation of moneys," in medical assistance for workers with disabilities, further providing for definitions and for medical assistance benefits for workers with disabilities and workers with medically improved disabilities.
The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:
Section 1. The definitions of "worker with a disability" and "worker with a medically improved disability" in section 1502 of the act of June 26, 2001 (P.L.755, No.77), known as the Tobacco Settlement Act, are amended and the section is amended by adding a definition to read:
Section 1502. Definitions.
The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
* * *
"Worker with a disability." An individual who meets all of the following:
(1) is at least 16 years of age [but less than 65 years of age;] and meets age requirements as established under applicable Federal law;
(2) is employed and receiving compensation;
(3) is eligible to receive Supplemental Security Income except for earnings and resources that exceed the limit established in section 1905 of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1396d(q)(2)(B));
(4) has monthly income below 250% of the Federal poverty income guidelines; and
(5) has countable resources equal to or less than $10,000.
"Worker with a medically improved disability." An individual who meets all of the following:
(1) is at least 16 years of age [but less than 65 years of age;] and meets age requirements as established under applicable Federal law;
(2) is employed at least 40 hours per month and is earning at least the applicable minimum wage under section 6 of the Fair Labor Standards Act of 1938 (52 Stat. 1060, 29 U.S.C. § 206);
(3) was previously a worker with a disability and participated in medical assistance;
(4) has monthly income below 250% of the Federal poverty income guidelines; and
(5) has countable resources equal to or less than $10,000.
"Worker with job success." An individual who meets all of the following:
(1) is at least 16 years of age and meets age requirements as established under applicable Federal law;
(2) is earning at least the minimum wage under section 6 of the Fair Labor Standards Act of 1938;
(3) has participated in a medical assistance for workers with disabilities category or a medical assistance for workers with medically improved disabilities category for the previous 12 consecutive months;
(4) has monthly income that is more than 250% of the Federal poverty income guidelines and less than 600% of the Federal poverty income guidelines; and
(5) may have countable assets in excess of $10,000 that have been developed since the individual's initial eligibility under this subsection.
Section 2. Section 1503 of the act is amended to read:
Section 1503. Medical assistance benefits for workers with disabilities [and], workers with medically improved disabilities and workers with job success.
(a) Program establishment.--There is established in the department a medical assistance purchase program for workers with disabilities [and], workers with medically improved disabilities and workers with job success. Appropriations to the department from [the fund] all sources of funds for the program shall be used by the department to provide medical assistance to a worker with a disability [or], a worker with a medically improved disability or a worker with job success.
(b) Worker with a disability [or], worker with a medically improved disability or worker with job success responsibilities.--[A worker with a disability or a worker with a medically improved disability seeking to purchase medical assistance benefits shall:
(1) Pay to the department or its designee 5% of the worker's monthly income in a manner to be determined by the department.
(2) Notify the department or its designee of any change in the worker's monthly income in a manner to be determined by the department.
(3) Failure of a worker with a disability or a worker with a medically improved disability to make payments in accordance with paragraph (1) will result in the termination of medical assistance coverage.]
(1) A worker with a disability or a worker with a medically improved disability seeking to purchase medical assistance benefits shall pay to the department or its designee 5% of the worker's monthly income in a manner to be determined by the department. Failure of a worker with a disability or a worker with a medically improved disability to make payments in accordance with this paragraph shall result in the termination of medical assistance coverage.
(2) A worker with job success seeking to purchase medical assistance benefits shall pay to the department or its designee 7.5% of the worker's monthly income in a manner to be determined by the department. Failure of a worker with job success to make payments in accordance with this paragraph shall result in the termination of medical assistance coverage.
(3) A worker with a disability, a worker with a medically improved disability or a worker with job success shall notify the department or its designee of any change in the worker's monthly income in a manner to be determined by the department.
(b.1) Payment.--A worker with job success who participates in medical assistance for workers with disabilities with income at or above $75,000 compounded by the cost-of-living increases granted by the Federal Government under the Social Security program annually since the year 2000 and who is seeking to purchase medical assistance benefits shall pay to the department or its designee 100% of the Commonwealth's average cost of the medical assistance for workers with disabilities program.
(b.2) Determination of eligibility.--Assets developed by a medical assistance for workers with disabilities enrollee who was made eligible under the job success category will not be counted in the determination of eligibility for the medical assistance for workers with disabilities program if the enrollee loses eligibility in the job success category.
(c) Provision of benefits.--Upon receipt of a worker's payment under subsection (b)(1), the department or its designee shall provide to the worker medical assistance benefits at the categorically needy level as defined by the department.
(d) Department responsibilities.--The department shall:
(1) Administer the medical assistance purchase program.
(2) [Prepare] Annually prepare and submit by November 30[, 2002, and annually thereafter] of each year a report to the chair and minority chair of the [Public Health and Welfare] Health and Human Services Committee of the Senate and the chair and minority chair of the Health [and Human Services] Committee of the House of Representatives on the number of individuals purchasing medical benefits, the average amount paid for the benefits and any other information deemed necessary by the department. The annual report shall be made available for public inspection and posted on the department's publicly accessible [World Wide Web site] Internet website.
Section 3. This act shall take effect in 180 days.
APPROVED--The 1st day of July, A.D. 2021.
TOM WOLF
