This manual letter lists new and revised material for the Health Care Programs Manual. Unless otherwise noted, new and revised instructions are effective January 1, 2007.
Chapter 03 - Eligibility Groups and Bases of Eligibility.
Chapter 04 - Social Security Administration (SSA) Benefits.
Chapter 21 - Income Calculation (Community).
Chapter 22 - Standards and Guidelines.
Chapter 24 - Medical Spenddowns.
The manual was updated with the following annual changes on December 15, 2006. These updates were announced in MAXIS email #7112766 dated December 19, 2006 and were also noted in the ”What’s New” section of the manual home page.
l The Pickle Disregard factor for 2007 is 1.033. See section 21.50.15.05, Pickle Disregard COLA Chart.
l The Blind/Disabled Student Child Disregard increases to $1,510 per month, with a $6,100 maximum per calendar year. See section 21.50.40, Blind or Disabled Student Child Disregard.
l The IRS mileage rate increases to 48.5 cents per mile. See section 22.30, IRS Mileage Rate.
l The maximum monthly income allowance for the community spouse increases to $2,541. See section 22.45, LTC Allowances.
l The minimum spousal asset allowance increases to $28,589. The maximum spousal asset allowance increases to $101,640. See section 22.40, Minimum/Maximum Asset Allowance.
l The clothing and personal needs allowance increases to $82. The special allowance for certain veterans remains $90. See section 22.45, LTC Allowances.
l The Special Income Standard (SIS) increases to $1,869 per month. See section 22.10, Special Income Standard.
Bulletin #06-21-14, Home Equity Limit for Medical Assistance (MA) Payment of Long-Term Care (LTC) Services
The following sections were updated with information from this bulletin. The new policies apply to applications and renewals filed on or after July 1, 2006.
l Section 07.05.05, Application Forms. Contains reorganized and updated information on LTC requests and applications, including:
n When to use the DHS-4803, the DHS-3543, or the HCAPP to request MA payment of LTC services.
n How and when to prohibit MA payment of LTC services while a request for payment is pending.
l Section 19.15.05, Jointly Owned Assets. Adds a subsection for LTC EW and links to section 19.55, Home Equity.
l Section 19.20, Verification of Assets. Adds an exception to LTC verification policy and links to section 19.55, Home Equity.
l Section 19.25, Asset Types. Adds a link to section 19.55, Home Equity.
l Section 19.25.15, Real Property. Adds a link to section 19.55, Home Equity.
l Section 19.25.15.05, Homestead Real Property. Adds a link to section 19.55, Home Equity.
l Section 19.55, Home Equity Limit. New section including:
n Definitions related to the home equity limit.
n Verification requirements.
n Steps for applying the home equity limit.
n Notice requirements.
l Section 19.55.05, Home Equity Limit Flowchart. New section which presents the steps found in section 19.55 in flowchart form.
l Section 19.55.10, Applying Home Equity Limit. New section with policy on when the home equity limit does and does not apply.
l Section 19.55.15, Home Equity Limit Exceptions. New section detailing who does not have the home equity limit applied when determining eligibility.
l Section 19.55.20, Calculating Home Equity. New section with instructions on how to calculate the home equity value for people who own the home solely, jointly or as a life estate.
l Section 19.55.25, Agricultural Homestead. New section which defines how to determine if property is an agricultural homestead and how to compute the equity value.
l Section 19.55.25.05, Agricultural Homestead Flowchart. New section which presents the information in section 19.55.25 in flowchart form.
l Section 19.55.30, Home Equity Limit Hardship Waiver. New section with instructions on how and when clients with home equity exceeding the limit may request hardship waivers.
l Section 23.50, LTC, EW and Assets. Adds a subsection on the home equity limit and links to section 19.55, Home Equity Limit.
Chapter 3, Eligibility Groups and Bases of Eligibility
l Section 03.30.20.05, MA-EPD Employment Definition. Changes policy so that federal or state work study income is now considered employment for MA-EPD if it meets certain conditions. The new policy is effective with receipt of this manual letter.
l Section 03.50.15, Legal Factors for GAMC. Updates the procedure for notifying DHS about GAMC cases that are denied or terminated due to drug addiction and/or alcoholism (DA&A).
Chapter 4, Social Security Administration (SSA) Benefits
l Section 04.15, SSI. Updates the maximum payment amounts for 2007 to $623 for an individual and $934 for a couple.
l Section 04.40.05, Medicare Part A. Removes the premium amount and adds a link to new section 22.55, Medicare Cost-sharing Amounts.
l Section 04.40.10, Medicare Part B. Updates information on how the Medicare Part B premium is determined using income reported on the annual tax return.
l Section 04.40.20, Medicare Part D, removes the premium amount and adds a link to new section 22.55, Medicare Cost-sharing Amounts.
l Section 04.40.20.05, Medicare Part D Premium, is deleted. The information is now in new section 22.55.
l Section 07.25, Withdrawing an Application. Clarifies that if an application has been acted upon for at least one member of the household it cannot be withdrawn. Pending applications that have not been approved or denied for any household member may be withdrawn.
Chapter 21, Income Calculation (Community)
l Section 21.50.25, RSDI COLA Disregard. Clarifies that the disregard applies to MA-EPD. This change was effective in January 2006 and was first announced in MAXIS e-mail #6781918 dated December 1, 2005, and again in MAXIS e-mail #7108080 dated December 13, 2006.
Chapter 22, Standards and Guidelines
l Section 22.55, Medicare Cost-Sharing Amounts. New section with Medicare Part A, Part B and Part D premium amounts for 2007.
Chapter 24, Medical Spenddowns
l Section 24.10.05, Automated Monthly Spenddown. Adds information on how MSHO enrollees pay their spenddowns to DHS.