Manual Letter #21

This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective April 1, 2009.

Bulletin #08-21-05, "Clarifications for MinnesotaCare Income Calculation and Redesigned Income Worksheet."

This bulletin was incorporated into the following sections:

l  Section 09.05.05 - Inconsistent Information.

l  Section 21.10 - MinnesotaCare Income Calculation.

l  Section 21.10.05 - MinnesotaCare Income Worksheet (New).

Chapter 02 - Minnesota Health Care Programs.

Most sections are slightly modified based on a regularly-scheduled review.

Chapter 14 - Living Arrangements.

Most sections are slightly modified based on a regularly-scheduled review.

Chapter 20 - Income.

The self-employment sections of Chapter 20 are updated based on a regularly-scheduled review.

Chapter 21 - Income Calculation (Community).

Most sections are slightly modified based on a regularly-scheduled review.

Other Updates.

Chapter 03 - Eligibility Groups and Bases of Eligibility.

Chapter 07 - Applications.

Chapter 19 - Assets.

Glossary A-F.

Glossary G-L.

Glossary M-R.

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Bulletin #08-21-05, "Clarifications for MinnesotaCare Income Calculation and Redesigned Income Worksheet"

Chapter 09 - Verification

n  Section 09.05.05 - Inconsistent Information.

Chapter 21 - Income Calculation (Community)

n  Section 21.10 - MinnesotaCare Income Calculation.

n  Section 21.10.05 - MinnesotaCare Income Worksheet (New).

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Chapter 02 - Minnesota Health Care Programs

This chapter was updated based on regularly-scheduled review.

l  Section 02 - Minnesota Health Care Programs (MHCP).

n  No policy changes.

n  Adds the words ”home and community-based” to all references to waiver programs to differentiate from other human services waivers.

n  Minor rewording for clarification.

l  Section 02.05 - Hierarchy of Major Programs.

n  No policy changes.

n  Deleted paragraph that refers to spenddowns as a form of cost-sharing, which is defined differently from a spenddown.  

n  Added Transitional MinnesotaCare to the Summary of Hierarchy.   

n  Minor rewording for clarification.

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Chapter 14 - Living Arrangements

l  Section 14 - Living Arrangements.

n  Provides information about living arrangements that are considered community settings and those that are facility living arrangements.

n  Moved the community living arrangement information to this page from section 14.05.

n  Adds information about types of facilities.

l  Section 14.05 - Institutions for Mental Diseases (IMD).

n  Formerly 14.10.10.   

n  Defines what is considered an IMD and explains importance of coding MMIS with correct living arrangement codes.

n  Removes duplicative information about adult enrollees who are in IMDs that is in Chapter 3.

l  Section 14.10 - Long-Term Care Facilities (LTCF).

n  Formerly 14.10.15.

n  Removes duplicative information that is in Chapter 3.

n  Removes information about Long-Term Care Consultations that is available in Chapter 23.

n  Adds that an MA enrollee who is absent from a LTCF on a leave day is still considered to be residing in a LTCF.

l  Section 14.15 - Correctional Facilities.

n  Formerly 14.10.20.

n  Revises information to differentiate between applicants and enrollees who reside in correctional facilities.

n  Clarifies that a MinnesotaCare enrollee who is incarcerated remains eligible for coverage until the next renewal.

n  Note added to inform that MA enrollees who reside in a correctional facility for no more than 12 consecutive months may request to have coverage reopened upon release from the facility through a shorted process.  A link to the bulletin explaining this process is provided.

l  Section 14.20 - Other Facilities.

n  Formerly 14.10.25.   

n  Adds information explaining non-negotiated rate facilities.

n  Adds information about Title IV-E certified facilities

Archived Chapter 14 sections:

n  Section 14.05 - Community Living Arrangements.

Information has been incorporated into section 14.00.

n  Section 14.10 - Facility Living Arrangements

Information has been incorporated into the pages for the specific facility living arrangements.

n  Section 14.10.05 - Children in Facilities.

Information has been incorporated into the section dealing with the specific type of facility.   

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Chapter 20 - Income

l  Section 20.25.20 - Self-Employment Income.

n  No policy changes.

n  Removes income calculation information and moves it to Chapter 21, Income Calculation.

n  Provides links to the MinnesotaCare and MA/GAMC self-employment pages for more specific information.

l  Section 20.25.20.05 - MinnesotaCare Self-Employment Income.

n  No policy changes.

n  Replaces ”Definitions” subsection with links to the pertinent glossary definitions throughout this section.

n  Adds chart listing types of self-employment and the tax forms required for each type.

n  Adds general overview of self-employment calculation steps.

n  Rewords several paragraphs to clarify policy.

l  Section 20.25.20.10 - MA/GAMC Self-Employment Income.

n  No policy changes.

n  Rewords the first paragraph to clarify that calculating self-employment differs for non-farm self-employed and farm self-employed businesses.  

n  Replaces ”Definitions” subsection with links to the pertinent glossary definitions throughout this section.

n  Minor wording changes for clarification.

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Chapter 21 - Income Calculation (Community)

This chapter was updated based on regularly-scheduled review.

l  Section 21 - Income Calculation (Community).

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

n  Eliminates the unnecessary use of ”countable” and instead uses gross or net income, as appropriate.

n  Adds additional information on net income.

n  Clarifies to use gross income for GAMC, GHO and Transitional MinnesotaCare and adds information on these income standards.  

l  Section 21.05 - Certification Period.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.10 - Determining Gross Income - MinnesotaCare.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.10.05 - MinnesotaCare Income Worksheet (New).

Provides step-by-step information for completing the new worksheet.

l  Section 21.15 - MA/GAMC Gross Income Determination.

n  No policy changes.

n  Removes definitions and provides links to the glossary where appropriate.

n  Explains change in procedure on entering unvarying income in MAXIS.

n  Reworded to align terminology throughout the chapter.

l  Section 21.20 - MinnesotaCare Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.20.05 - Excess Income - MinnesotaCare.

n  No policy changes.

n  Minor rewording to align terminology throughout the chapter.

n  Clarifies that income changes must be evaluated to determine if an increase causes ineligibility.

n  Removes the definition for Minnesota Comprehensive Health Association (MCHA) and adds a link to this term to the glossary.

l  Section 21.25 - MA Method A Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.30 - MA Method B Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

n  Adds a work expense deduction from earned income for blind basis of eligibility.

n  Clarifies the Impairment-related Work Expense deduction for people whose disability is blindness.

l  Section 21.35 - Medicare Savings Programs Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

n  Adds a work expense deduction from earned income for blind basis of eligibility.

n  Clarifies the Impairment-related Work Expense deduction for people whose disability is blindness.

l  Section 21.40 - MA-EPD Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.45 - GAMC and GHO Income Calculation.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.05 - Disabled Widow and Widower Disregard.

n  No policy changes.

n  Clarifies that this disregard is available to a widow or widower ages 50 to 65.

n  Clarifies that Medicare Savings Program enrollees may not use this deduction.

l  Section 21.50.10 - Widow and Widower Disregard.

n  No policy changes.

n  Corrected the last two statements under Conditions for Use from ”MA” to ”MSA” to read, ”Was eligible for SSI or MSA ” and ”Lost eligibility for SSI or MSA”

l  Section 21.50.15 - Pickle Disregard.

n  No policy changes.

n  Corrected Pickle Threshold Date.

n  Added MAXIS work-around to accommodate corrected Threshold date.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.15.05 - COLA Chart for Pickle Disregard.

n  No policy changes.

n  Corrects COLA amount for 2000 from 1.024 to 1.025.

n  Adds COLA amounts for years 1977 - 1981.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.20 - Disabled Adult Child (DAC) Disregard.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.25 - RSDI COLA Disregard.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.35 - Standard Deduction.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.40 - Blind and Disabled Student Child Disregard.

n  No policy changes.

n  Clarifies policy on who is considered a student.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.45 - Work Expense Deduction.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.50 - MA Method A Earned Income Disregard.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.55 - MA Method B Earned Income Disregard.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.60 - Dependent Care Deduction.

n  No policy changes.

n  Reworded to align terminology throughout the chapter.

l  Section 21.50.65 - Child Support Deduction.

n  No policy changes.

n  Changed ”non-custodial parents” to ”obligors” based on current usage in child support.

n  Reworded to align terminology throughout the chapter.

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Other Updates

Chapter 03 - Eligibility Groups and Bases of Eligibility

n  Section 03.25.20 - MA for Children in Foster Care.

Clarifies that children in foster care who have a six-month spenddown are eligible effective the date the spenddown is met (satisfaction date).

Chapter 07 - Applications

n  Section 07.15 - Who May Apply.

Clarifies requirements for a guardian or conservator acting as an authorized representative.

n  Section 07.15.10 - Authorized Representatives.

m Clarifies the role of the agency and power of attorney in determining and acting as the authorized representative.

m Adds information about termination or revocation of a power of attorney.

Chapter 13 - State and County Residence

n  Section 13.20 - Temporary Absence.

Clarifies that the time limit for a temporary absence depends on the reason for the absence.

Chapter 19 - Assets

n  Section 19.35.05 - MinnesotaCare Excess Assets.

Clarifies the example by adding that Susan has a household size of one.

n  Section 19.50 - Liens and Estate Recovery.

Replaces ”Definitions” subsection with links to the pertinent glossary definitions throughout this section.

Glossary

n  Section A-F.

m Conservator (revised).

n  Section G-L.

m Gross income (revised).

m Guardian (new).

m Legal Guardian (deleted).

n  Section M-R.

m Obligor (new).

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