Manual Letter #24

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

Bulletins Incorporated.

A number of bulletins have been incorporated into sections as listed throughout this manual letter.

Chapter 07 - Applications.

Many sections are modified based on a regularly scheduled review.

Chapter 08 - Renewals.

Many sections are modified based on a regularly scheduled review.

Other Updates

Chapter 02 - Minnesota Health Care Programs.

Chapter 03 - Eligibility Groups and Bases of Eligibility.

Chapter 05 - Client Rights.

Chapter 16 - Medical Support.

Chapter 17 - Household Composition.

Chapter 18 - Deeming Income and Assets.

Chapter 20 - Income.

Chapter 22 - Standards and Guidelines.

Chapter 25 - Premiums.

Chapter 30 - Other Related Programs.

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Bulletins Incorporated

l  Bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

l  Bulletin #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program."

l  Bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

l  Bulletin #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

l  Bulletin #09-21-02, "DHS Exempts Military Members Who Completed Tour of Active Duty and Their Families from Payment of MinnesotaCare Premiums."

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Chapter 07 - Applications

l  Section 07.05 - How to Apply.

n  Incorporates bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

n  Reminds workers to tell clients who call that they may send in a written request to set the date of application of MA or GAMC before submitting the application.

l  Section 07.05.05 - Applications for Health Care Programs.

n  Incorporates bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

n  Clarifies the Combined Application Form (CAF) can be used to apply for Minnesota Health Care Programs.

n  Adds information about the Minnesota Family Planning Program (MFPP) Application.

n  Clarifies that DHS-3182 is the only form that should be provided with the HCAPP.

l  Section 07.05.10 - Application Required.

n  Incorporates bulletins #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals" and #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

n  Clarifies policy for adding a member to a MinnesotaCare household when the only member is an auto newborn.

n  Clarifies policies that apply to applications for all Minnesota Health Care Programs.

l  Section 07.05.15 - Application Not Required.

n  Incorporates bulletins #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals" and #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

n  Clarifies provisions that apply to all Minnesota Health Care Programs.

l  Section 07.05.20 - Applications after Nonpayment of MinnesotaCare Premium (New).

Incorporates bulletin #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

l  Section 07.10 - Where to Apply.

Incorporates bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

l  Section 07.15 - Who May Apply.

Incorporates bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

l  Section 07.15.05 - Application Signature.

n  Clarifies that a signature is required from applicants who are age 18 or older at the time the application is processed.

n  Clarifies MinnesotaCare procedure for pending an application when a signature is needed.

l  Section 07.15.10 - Authorized Representative.

n  Clarifies that certain employees may not be authorized representatives for clients.

n  Clarifies that MAXIS sends notices to the authorized representative and the client.

l  Section 07.15.15 - Minnesota Health Care Programs (MHCP) and Incarcerated Individuals.

n  Incorporates bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

n  Changes the name of the section from Applications for Inmates.

l  Section 07.20 - Processing Applications.

Incorporates bulletins #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program" and #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

l  Section 07.20.05 - Date of Application.

n  Incorporates bulletin #07-21-11, "DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals."

n  Other minor clarifications.

l  Section 07.20.15 - Processing Periods.

Adds subsections to clarify policy for MinnesotaCare, MA and GAMC processing.

l  Section 07.20.20 - Updating an Application or Renewal

n  Adds information to include updating a renewal in this section.

n  Other minor clarifications.

l  Section 07.20.25 - Eligibility Begin Date.

n  Clarifies eligibility begin dates for MinnesotaCare.

n  Other minor clarifications.

l  Section 07.20.35 - MinnesotaCare with Retroactive MA.

Incorporates bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

l  Section 07.20.40 - Shared or Transferred Applications.

n  Incorporates bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)" and bulletin #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

n  Other clarifications for transferring applications between agencies.

l  Section 07.20.45 - How to Transfer and Receive an Application.

n  Clarifies MAXIS instructions.

n  Adds requirement to include citizenship and immigration documentation when transferring an application.

n  Clarifies to use the MHCP Application Transfer Letter (DHS-3358) to advise clients when their case is transferred.

l  Section 07.20.55 - Informed Choice (New).

Incorporates bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

l  Section 07.25 - Withdrawing an Application.

Clarifies process when clients change their decision to withdraw their application.

l  Section 07.30 - Case Notes.

n  Updates what to include in case notes, including citizenship documentation information, temporary absences, and self-employment income calculations.

n  Other minor clarifications.

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Chapter 08 - Renewals

l  Section 08.05 - Annual Renewal Exemptions.

n  Clarifies that Transitional Medical Assistance (TMA) enrollees, like Transition Year Medical Assistance (TYMA) enrollees, are exempt from renewals.

n  Clarifies that this section is about annual renewals; monthly and six-month renewal information is addressed on separate pages.

l  Section 08.10 - Renewal Forms.

n  Clarifies which forms can be used as renewals.

n  Clarifies which renewals may be processed as an application.

l  Section 08.20.05 - Processing MinnesotaCare Renewals.

n  Incorporates bulletin #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program."

n  Clarifies policy regarding late renewals and informed choice.

l  Section 08.25 - MA and GAMC Renewals

Minor clarifications.

l  Section 08.25.05 - Processing MA and GAMC Annual  Renewals.

n  Incorporates bulletin #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program."

n  Clarifies policy regarding late renewals.

n  Clarifies that this policy refers to annual renewals, including adding the word ”annual” to the title.

l  Section 08.35 - Six-Month Renewals.

n  Clarifies the use of the six-month renewal form.

n  Adds RMA enrollees as exempt from six-month renewals.

n  Other minor clarifications.

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Other Updates

Chapter 02 - Minnesota Health Care Programs

n  Section 02.05 - Hierarchy of Health Care Programs.

m Incorporates bulletin #08-21-10, "Introduction of ”Informed Choice” and Other Changes to Health Care Programs Application (HCAPP)."

m Changes the name of this section from Hierarchy of Major Programs to Hierarchy of Health Care Programs.

Chapter 03 - Eligibility Groups and Bases of Eligibility

n  Section 03.05.10 - MinnesotaCare Program Eligibility Type (MPET).

m Changes the minimum income for program FF from 200% to 215% FPG.

m Changes the minimum income for program JJ from 175% to 215% FPG.

m Deletes eligibility group A4.

m Deletes eligibility group M4.

m Deletes major program XX.

m Changes the minimum income for eligibility group M1 to 250% FPG.

n  Section 03.35.15 - Qualified Individuals (QI).

m Adds information on determining eligibility for QI for clients who are ineligible for MA due to excess income or are unable to meet a spenddown.

m Adds clarifying examples.

n  Section 03.45.05 - Emergency Medical Assistance (EMA).

m Clarifies not to apply sponsor deeming provisions for EMA.

m Clarifies that people may be eligible for EMA even if their sponsor does not respond to the Sponsor Letter.

Chapter 05 - Client Rights

n  Section 05.10 - Data Privacy.

Incorporates bulletin #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program."

Chapter 16 - Medical Support

n  Section 16.15.10 - Evidence of Good Cause.

Clarifies that a good cause committee will approve a client’s good cause request if they are a current Safe at Home participant and have a Safe at Home Identification Card.  

Chapter 17 - Household Composition

n  Section 17.20 - Adding a Household Member.

m Provides information on adding coverage for a current MinnesotaCare household member who did not previously have coverage.

m Incorporates bulletin #07-21-11, DHS Announces New Medical Assistance (MA) Policy for Processing Requests to Reopen MA for Incarcerated Individuals.

Chapter 18 - Deeming Income and Assets

n  Section 18.05 - Sponsor Deeming.

m Adds subsection to clarify not to apply sponsor deeming provision for EMA.

m Adds subsection to clarify there is no income limit for MA-BC or CVT so therefore, sponsor deeming does not apply when determining eligibility under these eligibility bases.

Chapter 19 - Assets

n  Section 19.20.05 - MA Asset Verification Denial/Closure.

Clarifies that eligibility for MinnesotaCare may be (not must be) determined if the denial or closure was due to more than just failure to verify assets.  

Chapter 20 - Income

n  Section 20.10 - Verification of Income.

Clarifies to use wage income verification if a self-employed client pays wages to another household member.

n  Section 20.25.20.05 - MinnesotaCare Self-Employment.

Clarifies to subtract wages and duplicative unearned income unrelated to the self-employment income for both self-employment and farm self-employment income.

Chapter 22 - Standards and Guidelines

Updates include the new 215 percent and 250 percent that were announced in bulletin #09-21-07, "Legislative Changes to MinnesotaCare for Certain Adults Effective July 1, 2009."

n  Section 22.05.10 - 100 Percent of FPG.

Removes MinnesotaCare major program FF, eligibility type M2 from list with income maximum of 100% FPG.

n  Section 22.05.30 - 175 Percent of FPG.

m MinnesotaCare Major Program Eligibility Type (MPET) FFM4 was eliminated April 1, 2009 and converted to FFM2 - less than or equal to 215% FPG .

m Deleted MinnesotaCare major program JJ, subgroup M, eligibility group 2 that will change to less than or equal to 215% FPG effective July 1, 2009.

m Deleted MinnesotaCare groups from the Minimum Income Limit for 175% FPG. There is no longer a minimum income limit for this standard.

n  Section 22.05.40 - 200 Percent of FPG.

m MinnesotaCare Major Program Eligibility Type (MPET) FFA4 was eliminated April 1, 2009.

m Deleted MinnesotaCare major program BB; the maximum for this MPET is less than or equal to 250% FPG effective July 1, 2009.

m Deleted MinnesotaCare major program FF, subgroup A, eligibility group 2 from the Minimum Income Limit for 200% FPG. There is no longer a minimum income limit for this standard.

n  Section 22.05.45 - 215 Percent of FPG (New).

This new standard is effective July 1, 2009, for MinnesotaCare major programs FF and JJ.   

n  Section 22.05.50 - 250 Percent of FPG (New).

This new standard is effective July 1, 2009, for MinnesotaCare major program BB.   

n  Section 22.05.55 - 275 Percent of FPG.

Changes standard for FFA2 to greater than 215% and less than or equal to 275% and MPET JJA2 to greater than 215% and less than or equal to 275%.

Chapter 25 - Premiums

n  Section 25.05 - MinnesotaCare Premiums.

Incorporates bulletin #09-21-02, "DHS Exempts Military Members Who Completed Tour of Active Duty and Their Families from Payment of MinnesotaCare Premiums."

n  Section 25.05.15 - MinnesotaCare Reinstatement.

Incorporates bulletin #08-21-11, "Health Care Determinations for Certain MinnesotaCare Enrollees Closed for Nonpayment of Premiums."

n  25.05.35 - Premium Exemption for Military Members and Their Families (New).

Incorporates bulletin #09-21-02, "DHS Exempts Military Members Who Completed Tour of Active Duty and Their Families from Payment of MinnesotaCare Premiums."

n  25.10.10 - Ongoing MA-EPD Premiums.

The address and fax number for sending MA-EPD Good Cause claims has changed.

Chapter 30 - Other Related Programs

n  Section 30.30 - Other Needs.

Incorporates bulletin #07-85-03, "DHS Issues Policy Information for the Safe at Home (SAH) Address Confidentiality Program."

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