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Effective: May 1, 2007 |
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03.45.35ar3 - Minnesota Family Planning Program (MFPP) (Archive) |
Archived: July 1, 2008 |
The Minnesota Family Planning Program (MFPP) is a Minnesota Health Care Program (MHCP) demonstration project to determine if access to pre-pregnancy family planning services will reduce the number of births from unintended pregnancies.
People may be eligible for family planning services through this program if they meet all of the following conditions:
l Are at least age 15 and no older than age 50.
n Children who turn age 15 in the month of application are eligible.
n Enrollees remain eligible through the month in which they turn 50.
l Are not pregnant. If an MFPP enrollee becomes pregnant:
n Advise her that she may be eligible for Medical Assistance (MA) or MinnesotaCare.
n Send a HCAPP and assist her with the application process.
n Close MFPP with ten-day notice.
n Do not act on reports of pregnancy from a third party or contact the third party. Contact the enrollee to confirm the pregnancy.
l Are not enrolled in other MHCP or DHS health services programs, including:
n MA.
n Medical Assistance for Breast/Cervical Cancer (MA-BC).
n Medical Assistance for Employed Persons with Disabilities (MA-EPD).
n Home and community-based waiver programs.
n Transitional MA or Transition Year MA (TMA /TYMA).
n General Assistance Medical Care (GAMC).
n MinnesotaCare.
n Consolidated Chemical Dependency Treatment Fund.
l Are not residents of an institution in which federally funded MA is not available.
County agencies, tribal agencies, and MinnesotaCare Operations are not processing MFPP applications at this time. However, agencies should be familiar with the MFPP and how it may impact other MHCP eligibility. Health care program workers should:
l Coordinate coverage between the MFPP and other health care programs as necessary.
l Refer questions about the MFPP to the DHS Family Planning Unit at 651-431-3480 or 888-702-9968.
l Provide the Minnesota Family Planning Program Application (DHS-4740) upon request.
l Forward completed MFPP applications to:
Minnesota Department of Human Services.
P.O. Box 64960.
St. Paul, MN 55164-0960.
l Account for administrative activities or directly billable activities associated with the MFPP within existing time studies. Code time related to the MFPP as you would for any other MA service or program.
Eligibility factors are listed below with any information that is unique for this group. Links to standard program guidelines are included as well.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Other Groups/Bases to Consider.
Application Process (standard guidelines)
People apply for the MFPP by:
l Submitting an MFPP application (DHS-4740) to the DHS Family Planning Unit. They can get applications by:
n Calling the DHS Family Planning Unit at 651-431-3480 (metro) or 888-702-9968 (outside metro area).
n Downloading an application from the DHS web site.
Note: Do not require the DHS-4740 if an applicant submits an application form designed for a different population, such as the HCAPP. Contact the applicant to gather any missing information.
l Applying with certain providers who can determine and grant presumptive eligibility for MFPP. See Application Process for MFPP for further information.
Eligibility Begin Date (standard guidelines)
The earliest eligibility begin date is the first day of the month in which the application was received. There is no retroactive coverage.
The month of application is the month in which the DHS Family Planning Unit receives a signed request for MFPP coverage.
l The request must include the applicant’s name, signature and a means to locate the applicant.
l The applicant must submit a completed application within 30 days of the date of the request.
For applicants who apply for ongoing coverage after being approved for presumptive eligibility, ongoing coverage begins the first day of the month following the end of the presumptive eligibility period.
Renewals (standard guidelines)
The eligibility period for the MFPP is 12 months. There are no six-month renewals.
l The DHS-4740 serves as the renewal as well as the application form.
l Renewals are mailed 14 business days from the end of the month prior to the month the case is scheduled to close.
l The renewal due date is the first day of the month coverage is to end.
l Process the renewal by the last day of the month coverage is to close. This applies both to renewals received by the due date and renewals received after the due date but before the closing date.
Example:
Robin’s MFPP coverage began on April 1, 2007 for the period April 1, 2007 through March 31, 2008. Her renewal due date is March 1, 2008. MMIS mails the renewal and closing notice on February 12, 2008. The completed renewal form is received on February 29.
Action:
Process the renewal by March 31, 2008 to allow continued coverage.
Verify the following:
l Earned and unearned income. See Verification of Income for specific requirements and verification sources.
l Citizenship and immigration status. See Verification of U. S. Citizenship and Verification of Immigration Status.
Social Security Number (standard guidelines)
All applicants and enrollees must apply for or provide a Social Security Number.
Exceptions:
l Applicants being screened for presumptive eligibility.
l Applicants and enrollees who provide convincing evidence that their refusal is based on well-established religious objections.
MFPP clients who declare they are U.S. citizens are not required to document their citizenship and identity as a condition of eligibility during the presumptive eligibility period. Obtain documentation for enrollees who file an application for ongoing coverage.
For noncitizens:
l Presumptive eligibility: Immigration status is not required.
l Ongoing MFPP: Enrollees must have an immigration status that qualifies them for federally funded health care.
Residency (standard guidelines)
Minnesota residents who meet the requirements in State Residence for MA/MinnesotaCare Families meet the state residence requirements for the MFPP.
MFPP applicants and enrollees may ”r;opt out” of providing information on other health insurance if they have concerns that reporting the information would violate their privacy.
Exception: The MFPP will not pay for prescription drugs covered under the Medicare prescription drug benefit. People who are eligible for Medicare Part D may not opt out of enrolling in Part D.
For applicants and enrollees who ”r;opt out” of providing health insurance information, the DHS Benefit Recovery Section (BRS) will not:
l Require the provider to bill the other health insurance.
l Seek reimbursement from any other health insurance.
l Include these enrollees on the ”r;finder file.”
l Create a recovery case for MFPP if MHCP opens retroactively for a period when MFPP was active.
l Send a Medical Services Questionnaire.
l Include information on other health insurance on the DHS eligibility verification systems (EVS/MN-ITS).
For applicants and enrollees who do not opt out and who provide information on other health insurance, submit the information to BRS following standard guidelines.
Exception: The MFPP will not reimburse cost-effective health insurance premiums. Do not submit any policies to BRS for a cost-effectiveness determination.
Household Composition (standard guidelines)
Follow MA/GAMC Adult’s Household Size to determine household size for all MFPP applicants and enrollees, including children under age 21. Parents and siblings are not counted in the child’s household size for the MFPP.
Follow MA Income Deeming and MA/GAMC Sponsor Deeming.
Exception: Do not deem the income of a spouse, parent or sponsor to applicants and enrollees under age 21.
Follow MA Method A to determine countable income.
There is no asset limit for the MFPP.
Annual income must be equal to or less than 200% FPG.
l For unvarying earned and unearned income:
n Multiply monthly income by 12.
n Multiply semi-monthly income by 24.
n Multiply biweekly income by 26.
n Multiply weekly income by 52.
l For varying income expected to be received throughout the year, determine an annual amount using the information on the application and income verification. See Determining Countable Income-MA/GAMC, Step 6.
Also see Seasonal Income - MA and GAMC and MA/GAMC Self-Employment Income - MA Method A.
Deductions/Disregards (standard guidelines)
Do not apply any earned or unearned deductions or disregards. Use gross countable income.
There are no spenddown or premium provisions for the MFPP.
Covered Services (standard guidelines)
The MFPP covers family planning services and supplies, including:
l Family planning-related office visits.
l Birth control prescriptions, devices and supplies.
l Sterilizations.
l Diagnosis and treatment of sexually transmitted diseases (STDs) found during a family planning visit.
l Diagnosis of HIV/AIDS found during a family planning visit.
The MFPP does not cover:
l Abortions.
l Infertility treatment.
l Family planning services provided in an inpatient setting.
l Treatment of HIV/AIDS.
Service Delivery (standard guidelines)
All MFPP services are provided through a fee-for-service delivery system.
MFPP enrollees must report changes in circumstances within ten days of the change.
Enrollees who fail to report a change that would have resulted in ineligibility for the MFPP are subject to a 12-month penalty period beginning with the date of disenrollment.
Examples of changes that could result in ineligibility and a penalty period include:
l Change in state residence.
l Institutional status, such as entering an IMD or correctional facility.
l Citizenship or immigration status, such as losing a status that qualifies for federally funded health care.
Do not apply a penalty period for failure to report a pregnancy within ten days.
Do not act on changes in income and household composition between renewals, unless the enrollee failed to report the change at renewal.
Do not refer minor MFPP enrollees to the IV-D Agency for medical support.
l Adult MFPP applicants and enrollees whose children are enrolled in MA or MinnesotaCare must cooperate with medical support requirements for the children as a condition of their own MFPP eligibility.
l If a caretaker enrolled in the MFPP fails to cooperate with medical support for an MA- or MinnesotaCare-enrolled child, the IV-D agency will notify the child’s MA or MinnesotaCare worker. The MA or MinnesotaCare worker must contact the DHS Family Planning Unit to coordinate closing the caretaker’s MFPP coverage.
People lose MFPP eligibility when they:
l Become pregnant.
l Die.
l Fail to submit a renewal before the closing date.
l Enroll in another MHCP or DHS health services program.
n Close MFPP with ten-day notice. The person may be open on the MFPP and the other program until MFPP can be closed.
l Lose Minnesota residency.
l Reach age 50. Eligibility ends the month after the month of the 50th birthday.
l Enter an institution where MA is not available.
l Are no longer citizens, nationals, or immigrants with a status eligible for federal funding.
l Voluntarily request closure.
Relationship to Other Groups/Bases (standard guidelines)
See Programs Overlap for information on the limited situations in which MFPP coverage may overlap with other health care programs.
Not applicable.