This manual letter lists new and revised material for the Health Care Programs Manual. Unless otherwise noted, new and revised instructions are effective October 1, 2011.
This manual letter incorporates the remaining portions of Bulletin #11-21-02, “Implementation of Medical Assistance for Adults Without Children Effective March 1, 2011,” as well as information in Bulletin #11-21-03, “Additional Guidance on Implementation of Medical Assistance for Adults Without Children.” Manual Letter #45 also incorporates into the Health Care Programs Manual Bulletin #11-69-01, “Disregard of Federal Tax Refunds as an Asset in Certain Public Programs,” and Bulletin #11-21-04, “Simplifying the Residency Requirements for MinnesotaCare Adults Without Children.”
Additional updates in this manual letter include the archival of information relating to the Minnesota COBRA Premium Subsidy, information relating to the Change Report Form, and clarification about asset reductions during the Medical Assistance (MA) processing period.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Incorporates Bulletins #11-21-02, #11-21-03, and #11-21-04; updates eligibility information for state-funded MA, and archives Section 03.45.40, MinnesotaCare COBRA Premium Subsidy.
Chapter 6 - Client Responsibilities
Adds information about the Change Report Form.
Incorporates Bulletin #11-21-02.
Chapter 12 - Certification of Disability
Incorporates Bulletin #11-21-03.
Chapter 13 - State and County Residence
Incorporates Bulletin #11-21-04.
Chapter 15 - Third Party Liability (TPL)
Revises information related to the Minnesota COBRA Premium Subsidy.
Incorporates Bulletin #11-69-01 and Bulletin #11-21-02, and clarifies information about asset reductions during the MA processing period.
Chapter 21 - Income Calculation (Community)
Incorporates Bulletin #11-21-02.
Chapter 22 - Standards and Guidelines
Updates the utility allowances for a Long-Term Care (LTC) income calculation.
Chapter 23 - MA Payment of Long-Term Care (LTC) Services
Incorporates Bulletin #11-21-02.
Chapter 24 - Medical Spenddowns
Incorporates Bulletin #11-21-02.
Chapter 29 - Quality Assurance
Incorporates Bulletin #11-21-04.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03 - Eligibility Groups and Bases of Eligibility.
Incorporates Bulletin #11-21-02 by adding a link to the new section, Medical Assistance for Adults Without Children.
l Section 03.10.10 - Change in Basis of Eligibility.
Incorporates Bulletin #11-21-03 by clarifying that a certification of blindness or disability would disqualify an applicant or enrollee for MA for adults without children.
l Section 03.20.25 - MinnesotaCare for Adults Without Children.
Incorporates Bulletin #11-21-02 by clarifying that a condition of eligibility for MinnesotaCare for adults without children is non-eligibility for MA for adults without children. Also, incorporates Bulletin #11-21-04 by removing a reference and link to the obsolete residency requirement for MinnesotaCare for adults without children, and adding a reference and link to the unified MinnesotaCare residency requirement.
l Section 03.30.25 - TEFRA Option.
Updates information to remove state-funded MA (NM) as a coverage option for children.
l Section 03.50 - Medical Assistance for Adults Without Children (New).
Incorporates policy provided in Bulletins #11-21-02 and #11-21-03 regarding eligibility for MA for adults without children.
The following page was archived due to the expiration of the Minnesota COBRA Premium Subsidy:
l Section 03.45.40 - Minnesota COBRA Premium Subsidy.
Chapter 6 - Client Responsibilities
l Section 06.10 - Changes in Circumstances.
Adds a reference and a link to the Change Report Form (DHS-4796).
l Section 07.20.55 - Informed Choice.
Incorporates Bulletin #11-21-02 by clarifying that applicants who are eligible for MA for adults without children are ineligible for MinnesotaCare for adults without children and are required to enroll in MA for adults without children.
Chapter 12 - Certification of Disability
l Section 12.10 - State Medical Review Team (SMRT) Disability Determinations.
Incorporates Bulletin #11-21-03 by clarifying that a SMRT referral is required for enrollees of MA for adults without children who indicate a disability, and requires that these enrollees cooperate with SMRT as a condition of eligibility.
Chapter 13 - State and County Residence
l Section 13.05 - State Residence for MA and MinnesotaCare.
Incorporates Bulletin #11-21-04 by updating the residency policy to include all MinnesotaCare applicants and enrollees, regardless of household composition. Also, updates the examples to conform to current policy.
The following page was archived due to the simplification of the MinnesotaCare residency requirement:
l Section 13.15 State Residence - MinnesotaCare Adults Without Children.
Chapter 15 - Third Party Liability
l Section 15.05 - MinnesotaCare Other Health Care Coverage Barriers.
Removes a reference to the newly archived Section 03.45.40 and added in the definition for the Minnesota COBRA Premium Subsidy.
l Section 19.05 - Asset Limits.
Incorporates Bulletin #11-21-02 by updating the policy to exclude MA Method A adults without children from asset limits.
l Section 19.05.10 - Exemptions from Asset Limits.
Incorporates Bulletin #11-21-02 by clarifying that applicants and enrollees eligible for MA for adults without children are exempt from asset limits.
l Section 19.10 - Excluded Assets.
Incorporates Bulletin #11-69-01 by adding a provision that allows for the exclusion of federal tax refunds for all Minnesota Health Care Programs (MHCP).
l Section 19.20 - Verification of Assets.
Incorporates Bulletin #11-69-01 by clarifying the process for reviewing an applicant’s or enrollee’s assets for federal tax refunds; also, incorporates Bulletin #11-21-02 by updating asset verification policy for MA Method A so that it includes only parents and relative caretakers.
l Section 19.35.10 - MA Excess Assets.
Removes the condition that no uncompensated transfers occur in order to backdate the eligibility to the first day of the month if an applicant reduces excess assets within the applicable processing period.
Chapter 21 - Income Calculation (Community)
l Section 21.50.45 - Work Expense Deductions.
Incorporates Bulletin #11-21-02 by clarifying that work expense deductions cannot be applied for applicants and enrollees of MA for adults without children.
l Section 21.50.60 - Dependent Care Deduction.
Incorporates Bulletin #11-21-02 by clarifying that dependent care deductions cannot be applied for applicants and enrollees of MA for adults without children.
l Section 21.50.65 - Child Support Deduction.
Incorporates Bulletin #11-21-02 by clarifying that child support deductions cannot be applied for applicants and enrollees of MA for adults without children.
Chapter 22 - Standards and Guidelines
l Section 22.45 - Long-Term Care (LTC) Allowances.
Updates the utility allowances that are effective October 1, 2011, through September 30, 2012.
Chapter 23 - MA Payment of Long-Term Care (LTC) Services
l Section 23 - MA Payment of Long-Term Care (LTC) Services.
Incorporates Bulletin #11-21-02 by clarifying that applicants and enrollees of MA for adults without children are not subject to an asset test or a transfer penalty.
Chapter 24 - Medical Spenddowns
l Section 24 - Medical Spenddowns.
Incorporates Bulletin #11-21-02 by clarifying that medical spenddowns are not allowed for applicants and enrollees of MA for adults without children unless they are living in a LTC facility.
Chapter 29 - Quality Assurance
l Section 29.20.05 - Determining Residency Following a PARIS Match.
Removes a reference to the newly archived Section 13.15, State Residence - MinnesotaCare Adults Without Children.