Manual Letter #14

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, 2008.

Eligibility Groups and Bases of Eligibility.

Several sections of Chapter 3 have been updated.

State and County Residence.

A number of Chapter 13 sections have been updated.


Several sections of Chapter 19 have been updated.

Other Updates.

HCPM Home Page - Inserted link to ”Health Care Eligibility for Noncitizens” guide on this page.

Chapter 07 - Applications, Eligibility Begin Date updated.

Chapter 11 - Add link to "Health Care Eligibility for Noncitizens" guide.

Chapter 22 - Standards, new Section 22.60.

Glossary - A number of new terms have been added and revised.

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Eligibility Groups and Bases of Eligibility

The following sections were updated:

l  Section 03.25.20 - Medical Assistance for Children in Foster Care.

An overview of foster care is added to this section, including information on the responsibilities of the Social Service Agency for placement, supervision and determining IV-E eligibility, information about the Minnesota Permanency Demonstration Project, and additional information on Medical Assistance (MA) eligibility for these children. There are other clarifications and additions throughout the section.  

l  Section 03.30.20 - Medical Assistance for Employed Persons with Disabilities.

n  Clarifies that applicants may choose which month(s) of Medical Assistance for Employed Persons with Disabilities (MA-EPD) to pay for and that eligibility is granted only for the months that are paid.  

n  In the Verifications subsection, adds clarification for when to refer MA-EPD applicants/enrollees with no disability determination to SMRT. Submit SMRT referral for people whose SSI or RSDI application is pending or being appealed, people who are not eligible for RSDI because they earn more than the substantial gainful activity (SGA) level, and people who have extended Medicare but are no longer receiving RSDI.

n  Exception and link added to the Household Composition subsection. Exception states MA-EPD enrollees who receive services through Home and Community-Based waiver programs should use the standard MA household size instead of the waiver household size.  

n  Changes made to clarify the Asset Guidelines subsection. A note is added to explain that the MA-EPD asset rules and asset limit should not be applied to MA-EPD enrollees who turn 65 and lose MA-EPD eligibility, but continue working.

n Statement added to the Income Guidelines and Deductions/Disregards subsections to clarify that there is no upper income limit for MA-EPD.

n  Link added to the Spenddown/Premiums subsection to an MA-EPD premium calculator on the DHS website.

n  Minor wording and formatting changes added throughout section to clarify policy.

l  Section 03.30.30 - Medical Assistance for 1619(a) and 1619(b).

Revisions provide more specific information, especially in the Insurance and Benefit Recovery section. Service Delivery information is updated for current policies on managed care enrollment and information is clarified with an example in the End of Eligibility Basis section.

l  Section 03.45 - Programs for Specific Populations.

The title of this section is changed from Health Care for Other Populations and defines who is included in the specific populations for whom there are special eligibility considerations.

l  Section 03.45.10 - Refugee Medical Assistance (RMA).

Updates information about the length and the begin date of RMA eligibility. Adds Iraqi and Afghan Special Immigrants to the list of immigration statuses potentially eligible for RMA. Clarifies that RMA enrollees are exempt from six-month renewals and sponsor deeming.

l  Section 03.50 - General Assistance Medical Care (GAMC).

Updates added to clarify differences between GAMC and GHO provisions.

l  Section 03.50.05 - General Assistance Medical Care (GAMC) with Full Benefits.

Updates and additions help clarify policy throughout this section.

l  Section - GAMC Qualifiers.

Clarifies that to be eligible for GAMC, an applicant or enrollee must have a GAMC qualifier and adds residing in the Minnesota Sex Offender Program as a qualifier.

l  Section 03.50.10 - General Assistance Medical Care - Hospital Only (GHO).

Clarifies that people who do not have a basis of eligibility for Medical Assistance (MA) and have income above 75% FPG and at or below 175% FPG may qualify for GHO. Information added regarding citizenship and immigration status requirements, plus other changes throughout.

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State and County Residence

l  Section 13.05 - State Residence for MA/MinnesotaCare Families.

n  Language added to clarify residency for a person who moves to Minnesota and establishes residence after the first day of the month. MA can begin no earlier than the date the person is physically present in the state with the intent to make Minnesota his or her home.

n  Adds steps to take when coordinating coverage with another state for people who move to Minnesota but have overlapping coverage in another state.

l  Section 13.05.10 - Migrant Agricultural Workers.

Corrects reference for state-funded programs for migrant agricultural workers who are not eligible for MA or MinnesotaCare for families.

l  Section 13.25 - County Residence.

n  Wording changes and clarification added throughout section.

n  Language added to clarify the roles and responsibilities of servicing and financially responsible counties.

n  Clarifies that counties should not delay eligibility determinations when a financial responsibility dispute arises.

n  Adjusts language for determining county of financial responsibility when an applicant moves.

n  Adds an example and language to clarify county of financial responsibility when a client is temporarily absent from their home.

l  Section 13.25.05 - Excluded Time.

n  Adds links to glossary terms for excluded time facilities.

n  Clarifies that receipt of adoption assistance and relative custody assistance are not considered excluded time.  

n  Removes reference to Group Residential Housing (GRH) because some GRHs are not excluded-time and the GRHs that are excluded-time, such as foster homes and board and lodge facilities, are already listed.

l  Section 13.25.15 - County Residence Disputes.

Incorporates changes from Bulletin #07-85-04, "Procedures for Deciding Financial Responsibility Disputes Between Counties."

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l  Section - Annuity Transfers.

Redirects workers to Bulletin #08-21-04, "Change in the Treatment of Annuities for Medical Assistance (MA) Payment of Long-Term Care (LTC) Services Eligibility and Benefit Recovery Announced."

l  Section - Annuity Life Expectancy Table.

Updates table references for evaluating annuities.

l  Section - Transfers Made for Purposes Other Than to Qualify for Medical Assistance.

The terms "uncompensated transfer" and "convincing evidence" are clarified in this section.

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Other Updates

HCPM Home Page

l  Added a link to the newly revised ”Health Care Eligibility for Noncitizens” guide.

Chapter 07 - Applications

l  Section 07.20.25 - Eligibility Begin Date.

Language is added to clarify eligibility begin date for new Minnesota residents.

Chapter 11 - Citizenship and Immigration Status

l  Section 11.00 - Citizenship and Immigration Status.

Added a link to the newly revised ”Health Care Eligibility for Noncitizens” guide.

Chapter 22 - Standards and Guidelines

l  Section 22.60 - Social Security Administration (SSA) Period Life Table.

Adds new table for evaluating annuities.


l  A - F.

The following terms have been added or revised in this section of the glossary:

n  Agency of Financial Responsibility (AFR).

n  Battered Women's Shelter.

n  Board and Lodging Facilities.

n  Break in Long-Term Care (LTC) Services.

n  County of Service.

n  Day Training and Habilitation.

n  Emergency Hold.

n  Emergency Shelter.

l  G - L.

n  Revised definition of ”Home” to include property in which an applicant or enrollee has an ownership interest.

n  The term ”Improper Transfer” is no longer relevant. Deleted from the glossary and replaced with more appropriate term, ”Uncompensated Transfer.”

l  M - R.

n  Added definition for ”Maternity Home” to this section.

n  Added definition for ”Refugee.”

l  S - Z.

n  Added definition for ”Servicing Agency (SV).”

n  Added definition for ”Uncompensated Transfer.”

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