This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective October 1, 2009.
Chapter 03 - Eligibility Groups and Bases of Eligibility.
Adoption Assistance sections are updated to clarify procedures; a number of other sections have updates on household composition and verification requirements.
Chapter 17 - Household Composition.
Many sections are modified based on a regularly scheduled review.
Chapter 14 - Living Arrangements.
Chapter 18 - Deeming Income and Assets.
Chapter 21 - Income Calculation
Chapter 24 - Medical Spenddowns.
Chapter 03 - Eligibility Groups and Bases of Eligibility
l Section 03.05.05 - Change in MinnesotaCare Eligibility.
Aligns FPG amounts with changes that were effective July 1.
l Section 03.25.25 - Medical Assistance for Children Receiving Adoption Assistance.
n Clarifies existing Adoption Assistance policy.
n Adds information about children adopted in other states who move to Minnesota. These children are automatically eligible for MA when they move to Minnesota under the Interstate Compact on Adoption and Medical Assistance (ICAMA).
l Section 03.25.25.05 - Interstate Compact on Adoption and Medical Assistance (ICAMA) (New).
n Provides MA eligibility policy and procedures for ICAMA children.
n Clarifies that children who receive IV-E or state-funded Adoption Assistance through another state are automatically eligible for MA when they move to Minnesota.
l Section 03.30.20.05 - MA-EPD Employment Definition.
Clarifies that business records can be used in lieu of tax forms to verify income for MA-EPD self-employment income if there is a significant change in income or expenses since the most recent federal taxes were filed.
l Section 03.35 - Medicare Savings Programs.
Adds an introductory statement to explain that Medicare Savings Programs generally follow MA policy.
l Section 03.35.05 - Qualified Medicare Beneficiary (QMB).
n Updates Household Composition subsection to align wording with all related sections and link to information about determining household size and exceptions to MA and GAMC household size in Chapter 17.
n Clarifies household size policy when a person is not requesting Elderly Waiver (EW) but his or her spouse is eligible for the EW.
l Section 03.35.10 - Service Limited Medicare Beneficiary (SLMB).
n Updates Household Composition subsection to align wording with all related sections and link to information about determining household size and exceptions to MA and GAMC household size in Chapter 17.
n Clarifies household size policy when a person is not requesting Elderly Waiver (EW) but his or her spouse is eligible for the EW.
l Section 03.35.15 - Qualified Individuals (QI).
n Updates Household Composition subsection to align wording with all related sections and link to information about determining household size and exceptions to MA and GAMC household size in Chapter 17.
n Clarifies household size policy when a person is not requesting Elderly Waiver (EW) but his or her spouse is eligible for the EW.
l Section 03.35.20 - Qualified Working Disabled (QWD).
n Updates Household Composition subsection to align wording with all related sections and link to information about determining household size and exceptions to MA and GAMC household size in Chapter 17.
n Clarifies household size policy when a person is not requesting Elderly Waiver (EW) but his or her spouse is eligible for the EW.
l Section 03.45.05 - Emergency Medical Assistance (EMA).
n Clarifies that applicants for EMA do not have to provide verification of citizenship or immigration status.
n Clarifies that applicants for EMA do not have to comply with sponsor deeming or Social Security number requirements.
Chapter 17 - Household Composition
l Section 17 - Household Composition.
n Deletes references to ”legal” guardian; all guardians are appointed by a court, and therefore, are legal.
n Removes definitions from this section and links to them in the glossary when they are used within the text.
n Minor clarifications and updates.
l Section 17.05 - Determining Household Size for MA and GAMC.
n Clarifies to base the determination of a child’s home on current circumstances and to use custody information from a court order only in contested cases.
n Rearranges examples so they directly follow the related policy.
n Minor clarifications and updates.
l Section 17.05.05 - Exceptions to MA/GAMC Household Size.
n Clarifies information in the long-term care (LTC) section and moves the information about waivers to this subsection, since waivers are LTC.
n Clarifies the EW exception to household size for Medicare Savings Programs (MSP) and aligns wording with other MSP sections.
l Section 17.10 - Household Size for MinnesotaCare.
n Adds information and examples about including an unborn child in the pregnant woman’s household.
n Minor clarifications and updates.
l Section 17.10.05 - Three Generation Households.
n Clarifies to include the minor child’s other parent or any siblings of the minor parent or minor child in the household.
n Clarifies to create a new case for the minor parent’s child and the parent of that child who is only included in the first household because of the parental relationship to the child.
n Minor clarifications and updates.
l Section 17.10.10 - Non-Parent Caretaker.
n Clarifies that stepparents are counted the same as biological parents when looking at the non-parent caretaker household for MinnesotaCare.
n Deletes references to ”legal” guardian; all guardians are appointed by a court, and therefore, are legal.
n Minor clarifications and updates.
l Section 17.10.15 - All or Nothing Rule.
n Adds a subsection to clarify citizenship and immigration requirements for the All or Nothing Rule.
n Minor clarifications and updates.
l Section 17.20 - Adding a Household Member.
n Adds an example for enrolling an auto newborn in the same managed care plan as his mother.
n Notes to send a MAXIS e-mail to MADE if the addition of a household member changes an MA-EPD enrollee’s premium.
l Section 17.25 - Removing a Household Member.
n Clarifies that if one or more household members must be removed from a case to a separate case they must have signed an application or renewal in order to establish a separate case without a new application.
n Adds MA-EPD Premium and Part B premium reimbursement to the list of other sections to review when removing a person from a household.
Chapter 14 - Living Arrangements
n Section 14.15 - Correctional Facilities.
m Clarifies that both correctional and detention facilities prohibit health care program eligibility.
m Changes terminology from ”county jail” to ”county correctional or detention facility.”
m Clarifies that a person furloughed from a county facility to a chemical dependency treatment program is eligible for continued GAMC coverage if he or she is eligible for GAMC while in treatment, will return to the county facility after treatment, and has less than 12 months remaining to serve upon returning to the correctional facility.
Chapter 18 - Deeming Income and Assets
n Section 18 - Deeming Income and Assets.
Adds a new subsection regarding Medicare Savings Programs Income and Asset Deeming.
n Section 18.05 - Sponsor Deeming.
m Clarifies that applicants for EMA do not have to provide verification of citizenship or immigration status.
m Clarifies that applicants for EMA are not required to comply with sponsor deeming requirements.
n Section 19.25.15.10 - Non-Homestead Real Property.
m Adds additional information about clients who dispute the estimated market value (EMV) of their property.
m Clarifies examples.
n Section 19.25.30.15 - Evaluation of Annuities under Transfer Policy.
Clarifies uncompensated transfer value for both Method 1 and Method 2.
n Section 20.25.35 - RSDI and SSI.
Removes long-term care (LTC) from applicable programs because policy does not pertain to LTC.
Chapter 21 - Income Calculation (Community)
n Section 21 - Income Calculation (Community).
Corrects the 200% FPG standard to 250% FPG to align with changes effective July 1.
n Section 21.20.05 - Excess Income and MinnesotaCare.
m Clarifies to not change the Major Program Eligibility Type (MPET) or premium of any household member when closing coverage for the end of the month following the month in which excess income is determined.
m Adds examples to help clarify when to close coverage.
Chapter 24 - Medical Spenddowns
n Section 24.20 - Inpatient Hospitalization - MinnesotaCare Enrollees.
Corrects the 175% FPG standard to 215% FPG to align with changes effective July 1.
Adds four new terms to the glossary.
n Developmental Disabilities (DD) Waiver.
n Interstate Compact on Adoption and Medical Assistance (ICAMA).
n Qualified Medical Support Order.
n Subsidized Adoption.