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Effective: March 1, 2007 |
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03.50.15ar3 - Legal Factors for GAMC (Archive) |
Archived: October 1, 2008 |
All General Assistance Medical Care (GAMC) applicants must complete the Required Questions for GAMC (DHS-3423) at the time of application to confirm that they meet certain legal and other criteria. The DHS-3423 is required only at application; do not require it at renewal.
Exception: General Assistance (GA) recipients, who have automatic eligibility for GAMC, are not required to complete the DHS-3423.
In addition to legal factors, the DHS-3423 includes questions about past receipt of Supplemental Security Income (SSI) or Retirement, Survivors, and Disability Insurance (RSDI).
Note: GAMC applicants who use the Combined Application Form, or CAF (DHS-3469) (instead of the HCAPP) must also complete the DHS-3423. Some of the required questions are included on the CAF, but not all of them.
Fraudulent Statements About Residence.
Violating Parole or Probation.
GAMC applicants must complete the form before eligibility may be approved. The form must be returned within the application processing period.
If the answer to all of the required questions is "No," then the applicant has met this eligibility requirement. If the answer to any of the required questions is "Yes," then the applicant may be ineligible for GAMC. See below for more information about the conditions that may result in a GAMC applicant's ineligibility, and the conditions under which the applicant may become eligible, if any.
Note: Do not disqualify other household members because of the GAMC applicant's ineligibility. Continue to deem the ineligible member's income and assets.
People are ineligible for GAMC if they admit in writing on the DHS-3423 that they were convicted of a drug felony on or after July 1, 1997. This disqualification also applies if the county agency has other reliable verified documentation that a person has been convicted of a drug felony.
A person convicted of a drug felony is ineligible for five years from the date of completion of the terms of the court-ordered sentence, unless the person meets any of the following conditions:
l Participates in a drug treatment program.
l Has successfully completed a drug treatment program.
l Has been assessed as not needing a drug treatment program.
People who meet one of the above conditions are eligible for GAMC if they meet all other eligibility requirements. However, the convicted person is subject to random drug testing as a condition of eligibility. DHS suggests that county agencies coordinate efforts with local probation or court services to establish procedures and share costs of random drug testing for these clients.
If the client fails a drug test, or the county is informed by a probation officer or other official entity that the client has failed a drug test, the client is ineligible for assistance for five years beginning the first of the month following the month of the positive test result for an illegal controlled substance.
Note: A subsequent drug conviction while receiving assistance results in ineligibility for the convicted person beginning the month after the date of conviction, and continuing for five years after completion of sentence.
Fraudulent Statements About Residence
People are ineligible for GAMC if they admit in writing on the DHS-3423 that they have been convicted of making a fraudulent statement about their place of residence in order to receive duplicate medical assistance simultaneously within a state or from two or more states.
These people are ineligible for ten years from the date of conviction. This disqualification also applies if the county agency has other reliable verified documentation that the client has been convicted of fraud based on false statements about residency.
People are ineligible for GAMC if they admit in writing on the DHS-3423 that they are currently fleeing prosecution, custody, or confinement after being convicted of a felony.
This disqualification also applies if the county agency has other reliable verified documentation that the client is a fleeing felon. Fleeing felons are ineligible until they provide documentation that the issue has been resolved.
People are ineligible for GAMC if they admit in writing on the DHS-3423 that they are currently in violation of a condition of probation, parole, or supervised release.
This disqualification also applies if the county agency has other reliable verified documentation that the client is a parole violator. Parole violators are ineligible until they provide documentation that they are no longer in violation.
People are ineligible for GAMC if they received SSI or RSDI that ended after March 29, 1996 because of drug addiction and/or alcoholism (DA&A).
l If the applicant responds "yes" to this question, close GAMC with 10-day notice. Include the following comment on the notice:
"You cannot get GAMC because your SSI and/or RSDI benefits ended after March 29, 1996 due to drug addiction and/or alcoholism. This change was approved by the MN Legislature in 1997 but was delayed until the 2001 Special Legislative session. The law passed in 2001 is: 2001 MN Laws First Special Session, Chapter 9, Article 10, Section 62."
l If the applicant responds "no" to this question but the case record contains contradictory information:
n Submit a question to DHS via HealthQuest with a heading of "DA&A Review."
n Fax all necessary documentation to (651) 431-7446.
n If the applicant is otherwise eligible, continue eligibility unless the HealthQuest response directs otherwise.
l Cases that are denied or terminated due to DA&A must be tracked manually by DHS. If you deny or terminate GAMC due to DA&A, send or fax information to the HCEA Policy Support Unit:
HCEA - Policy Support Unit,
P.O. Box 64989,
540 Cedar Street,
St. Paul, MN 55164-0989.
Include the following information in your faxed or mailed document:
RE: DA&A Denial/Termination.
(Enrollee Name) (PMI Number) has been denied/terminated from GAMC due to DA&A effective (date). S/He answered "yes" to DA&A.