*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: December 1, 2006 |
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03.25.35.15 - Reporting Requirements for TYMA |
Archived: June 1, 2016 |
Quarterly reports are required for people with a TYMA basis of eligibility.
Second and Third Quarterly Reports.
The household must contain a dependent child throughout the TYMA eligibility period. Send the Transition Year Medical Assistance First Quarterly Report (DHS-2975A) at the end of the third month of TYMA eligibility.
l If the enrollee returns the form indicating there is no longer a dependent child in the home, close TYMA for the first month for which you can give ten-day notice. Determine if MA eligibility continues under another basis.
l If the enrollee does not return the form, assume the household still contains a dependent child. It is not necessary to monitor the return of the first quarterly report.
Second and Third Quarterly Reports
TYMA enrollees must report earnings and child care costs for the previous three months by the 21st day of the seventh and tenth months of the TYMA period. No verification is required. If you need information not available in the case record and you cannot obtain the information by telephone:
l Send the Transition Year Medical Assistance Quarterly Report (DHS-2975).
l Enrollees may choose to report the information by telephone rather than return the DHS-2975.
If the enrollee does not report timely, do one or more of the following:
l Attempt to reach the enrollee by telephone to obtain the earnings and child care costs information.
l Follow up by mail if you are unable to reach the enrollee by telephone.
l Check the case record to see if the necessary information is available. For example, the household may have submitted monthly or six-month report forms for other program eligibility. If so, use the information in the case record to meet the reporting requirement.
Example:
Joan and her daughter begin receiving TYMA in January. Her husband Roy remains on MA Method B and submits six-month income renewals because the household has varying income. Joan must report gross earnings and child care costs for July-September in October (the seventh month of TYMA). Roy submitted a six-month income renewal form in August which included the household’s July earnings and child care costs.
Action:
Obtain earnings and child care cost information for August and September to determine if average gross earnings less actual child care costs are equal to or less than 185% FPG for July-September.
If the reporting requirement for the second or third quarterly report is not met through any of the above methods, suspend TYMA with ten-day notice.
l If the enrollee later reports the necessary information and remains eligible, reopen TYMA effective the first day of the following month for the remainder of the original 12-month period.
l If the enrollee does not report, continue to monitor the suspended case. Suspended cases remain active on the worker’s MAXIS caseload.
n Do not close the case for non-reporting until the end of the 12-month period.
n Send subsequent quarterly reports if needed.
n Send a notice of closing during the 12th month, ensuring ten-day notice.
For further information on how to determine TMA/TYMA eligibility, see:
Transitional MA/Transition Year MA (TMA/TYMA).
Potential Eligibility for TMA/TYMA.
Concurrent Eligibility for TMA/TYMA.
New Household Members for TMA/TYMA.