Manual Letter #6

This manual letter lists new and revised material for the Health Care Programs Manual. Unless otherwise noted, new and revised instructions are effective August 1, 2007.

Chapter 03 - Eligibility Groups and Bases of Eligibility.

Chapter 07 - Applications.

Chapter 08 - Renewals.

Chapter 11 - Citizenship and Immigration Status.

Chapter 17 - Household Composition.

Chapter 19 - Assets.

Chapter 20 - Income.

Chapter 22 - Standards and Guidelines.

Chapter 23 - Long-Term Care and Elderly Waiver.

Chapter 24 - Spenddowns.

Chapter 30 - Other Related Programs.

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Chapter 03 - Eligibility Groups and Bases of Eligibility

l  Section 03.30.20 - Medical Assistance for Employed Persons with Disabilities (MA-EPD).

Updates the wording of the second bullet under ;Insurance and Benefit Recovery” to emphasize that MA-EPD enrollees must have income no greater than 200% FPG and not be eligible for QMB or SLMB to qualify for reimbursement of Medicare Part B premiums, and to highlight deeming policy for each of these factors.

l  Section 03.35 - Medicare Savings Programs.

Clarifies that people may not be enrolled in GAMC and QMB at the same time, and adds information about policy considerations for choosing one or the other, under "Relationship to Other Program Eligibility."

l  Section - Presumptive Eligibility Providers for MA-BC.

Clarifies that authorized providers approve presumptive eligibility for a minimum of 30 days from the application date, and updates the list of current presumptive eligibility providers.

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Chapter 07 - Applications

l  Section 07.05.15 - Application Not Required.

Changes the time frame after which a new application is required from six to eleven months under ”MCRE Application Not Required.” The law requiring six-month renewals for MinnesotaCare was repealed July 1, 2007.

Adds that an application is not required when a household member who is already counted in the household size requests coverage under ”MA/GAMC Application Not Required,” and adds a link to section 17.20, Adding a Household Member.

Removes an obsolete reference to people entering an IMD under "MA to GAMC Program Change."

l  Section 07.20.45 - How to Transfer and Receive an Application.

Clarifies that it is the most recent, not necessarily the original, application that should be sent to the receiving agency under ”Transferring the Application.”

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Chapter 08 - Renewals

l  Section 08.20 - MinnesotaCare Renewals.

Corrects timelines in the examples and adds text about the system-determined redetermination date.

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Chapter 11 - Citizenship and Immigration Status

l  Section 11.05 - Verification of U.S. Citizenship.

Corrects ”state-funded foster care” to ”non-IV-E foster care” under ”Foster Care and Adoption Assistance." In Minnesota, for foster children who are not eligible for Title IV-E funds, the placement is covered by a combination of state and county funding.

Also clarifies when to obtain documentation of citizenship and identity for auto newborns under ”When Must Documentation Be Provided?”. Identity can be verified at the next renewal, while documentation of citizenship must be obtained from the earliest available source.

l  Section 11.05.05 - Acceptable Documentation.

Adds that a final adoption decree can be used to document citizenship of children born in the United States, as well as for noncitizen children adopted by U.S. citizen parents, under ”Level 2.” Adds that a letter from the adoption agency is also acceptable documentation.

Also corrects language under "Level 2" as to whom these provisions apply. This language previously stated that these provisions applied to noncitizen children who were born outside of the U.S. after March 1, 2001. The language has been corrected to specify that these provisions apply to noncitizen children who met the listed criteria on or after February 27, 2001.

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Chapter 17 - Household Composition

l  Section 17.05 - Determining Household Size for MA and GAMC.

Corrects the first example (under ”MA/GAMC General Household Size Policy”). Antonio will increase his parent’s household size in May, which is the first full calendar month he is in the household. This was previously incorrectly stated as June.

Also makes minor formatting changes to ”MA/GAMC General Household Size Policy” for greater clarity.

l  Section 17.15 - Temporary Absence.

Adds incarceration under ”What Is Not a Temporary Absence?”

l  Section 17.20 - Adding a Household Member.

Adds a link to section 07.05.15 (Application Not Required) to highlight that an application is not required when a person who is already counted in the MA/GAMC household size requests coverage.

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Chapter 19 - Assets

l  Section 19.40.25 - Determining Uncompensated Value.

Adds a brief description of what a notarized agreement must contain, and adds that a notarized agreement is not needed if the care is provided by a person who is not a relative, under ”MA and GAMC.”

l  Section 19.45 - Asset Assessments.

Adds a definition for receipt of home and community-based services for purposes of the asset assessment under ”Determining the Asset Assessment Effective Date.”

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Chapter 20 - Income

l  Section 20.05 - Excluded Income.

Makes minor changes to link and text in introductory sentences to clarify when to refer to the policy in section 23.40.10, LTC Excluded Income.

Corrects "state-funded foster care" to "non-IV-E foster care."

l  Section 20.05.05 - Program Provisions for Excluded Income.

Adds links to section 20.25.10, Lump Sum Income, to highlight the importance of considering lump sum income when determining total countable income, under ”Excluded Income - MA Method A” and ”Excluded Income - MA Method B.”

Adds EMSA as an excluded emergency payment for MA Method A and MA Method B. Also removes references to payments made by EA (Emergency Assistance); the program was repealed in 2003.

l  Section 20.15 - Verification of Income.

Replaces reference and link to obsolete DHS-3541, Consent for Release of Employment Information, with reference and link to the DHS-2146, Authorization for Release of Employment Information, under ”MA-EPD.” Also moves the "Mae" example that was under "MinnesotaCare" to "General Provisions."

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Chapter 22 - Standards and Guidelines

l  Section 22.15 - MCHA Premiums.

Updates the Minnesota Comprehensive Health Association (MCHA) premium amounts that were effective July 1, 2007. This update was previously announced in MAXIS email #7272913 (dated June 13, 2007).

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Chapter 23 - Long-Term Care and Elderly Waiver

l  Section 23.05 - Elderly Waiver.

Corrects the statement under ”EW and AC” that the client must appear to be eligible for MA within 180 days of receipt of AC services to 135 days. This change was previously announced in bulletin #05-25-06, ”Alternative Care Program Implements 2005 Legislative Changes,” and was effective September 1, 2005 for new applicants and no later than December 31, 2005 for participating clients.

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Chapter 24 - Spenddowns

l  Section 24.15 - Health Care Expenses.

Under ”Whose Health Care Expenses Are Allowed,” changes text and adds examples to clarify when a person’s bills can be used to meet the spenddown of other household members.

Clarifies that bills applied to a spenddown, whether or not the spenddown was met, cannot be applied to future spenddowns unless eligibility was denied for the entire certification period.

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Chapter 30 - Other Related Programs

l  Section 30.10 - Medical Needs.

Removes adult foster care, assisted living and residential care from the list of covered services under ”Alternative Care (AC).” This change was previously announced in bulletin #05-25-06, ”Alternative Care Program Implements 2005 Legislative Changes,” and was effective September 1, 2005.

Under ”Minnesota Children with Special Health Needs (MCSHN),” updates the phone number for the Twin Cities Metro area to 651-201-3650. There is no change to the toll-free number.

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