Medicaid waivers; consumer-directed services, employer of record.

Plain English Breakdown

The official source material does not provide information about potential impacts on tax compliance or benefit taxation, which were included in the candidate explanation.

Medicaid Waivers for Consumer-Directed Services

This bill directs the Department of Medical Assistance Services (DMAS) to modify Medicaid rules so that individuals receiving services can act as their own employer and appoint another person to manage their care when needed.

What This Bill Does

• Allows individuals who receive Medicaid services through certain waivers to serve as their own employer for those services.
• Permits these individuals to designate another individual to perform all or a portion of the duties related to being an employer when they are unable to do so themselves.
• Specifies that if someone is under age, ineligible to use their existing EIN, or deemed ineligible by DMAS rules, a new EIN will be assigned and not transferred.
• Limits how often individuals can designate another person as their employer of record to no more than twice per calendar year.

Who It Names or Affects

• People who receive Medicaid services through certain waivers.
• The Department of Medical Assistance Services (DMAS).

Terms To Know

Employer of Record (EOR)

A person or entity responsible for managing the employment relationship and ensuring compliance with labor laws.

1915(c) Waivers

Special Medicaid waivers that allow states to provide home and community-based services to individuals who would otherwise require institutional care.

Limits and Unknowns

• The bill does not specify the exact process for assigning or transferring EINs.
• DMAS has authority to limit the frequency of designations but specifics on enforcement are not detailed.

Official Summary Text

Department of Medical Assistance Services; Medicaid waivers; consumer-directed services; employer of record.
Directs the Department of Medical Assistance Services (DMAS) to modify the program rules for consumer-directed services available through certain Medicaid waivers to allow an individual receiving services to serve as the employer of record (EOR) for his own service delivery and designate another individual to perform all or a portion of the duties of the EOR on the individual's behalf when the individual receiving services is unable to perform such duties or direct his own care. The bill specifies that when an individual (i) has not yet reached the age of majority, (ii) is ineligible to use his existing employer identification number (EIN) to facilitate the taxation of benefits, or (iii) is otherwise determined to be ineligible by DMAS by administrative rule, the EIN shall be assigned to the individual receiving services and shall not be transferred to another individual. Under the bill, DMAS has the authority to limit such amendments to specify that an individual receiving services may make such designation no more than twice per calendar year.

Current Bill Text

A BILL to direct the Department of Medical Assistance Services to submit state plan amendments to the Centers for Medicare and Medicaid Services to seek to modify the program rules for consumer-directed services available through certain Medicaid
waivers
.

Be it enacted by the General Assembly of Virginia:

1.
§ 1.
That the Department of Medical Assistance Services (DMAS) shall seek federal authority through the necessary state plan
or 1915(c) waiver
amendments
submitted to the Centers for Medicare and Medicaid Services
under Titles XIX and XXI of the Social Security Act to modify the program rules
for
consumer
-
directed services available through

certain
1915(c) Home and Community
-
Based Services Medicaid
W
aivers
to allow
an
individual
receiving services
to
serve as the

e
mployer of
r
ecord
(EOR)
for
his
own service delivery
and

designate another individual to perform all or a portion of the
d
uties of the
EOR
on the individual
'
s behalf when the individual receiving services is unable
to perform such duties or direct
his
own care.

In seeking federal authority
to modify such rules
, DMAS shall ensure that
the
employer identification number (
EIN
)
shall be assigned to the individual receiving services and shall not be transferred to another individual except

w
hen an individual (i) has not yet reached the age of majority, (ii) is ineligible to use
his
existing
EIN
to facilitate the taxation of benefits, or (iii)
is
otherwise determined
to be ineligible
by
DMAS
by administrative rule.

DMAS

shall have the authority to
limit
such state plan or 1915(c) waiver
amendments to
specify that

an individual receiving services may make
such
designation

no more than twice per calendar year.