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, 2012.
This manual letter incorporates Bulletin #11-21-10, "Changes to Medical Assistance (MA) Transfer Penalty Policy", and Bulletin #11-21-11, "Eliminating the Addback of Depreciation for MinnesotaCare Farm Self-Employment Income."
Manual Letter #48 also includes annual updates as well as updates related to the revision of the Minnesota Health Care Programs Application (HCAPP).
This manual letter also includes the publication of the "2012 Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense." In addition to the document being updated to reflect all Medicare part D plans in Minnesota for 2012, this document also has been redesigned and includes an instructions page that defines the information provided in each column of the chart.
Additional revisions were made to sections for asset verification, applying for other benefits, Medicare referrals, TRICARE and CHAMPVA coverage, and the MinnesotaCare All or Nothing Rule.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Adds adults without children as an MA basis of eligibility. Also, adds a related topics link for the Medicare Savings Programs (MSP).
Chapter 4 - Social Security Administration (SSA) Benefits
Provides clarification on the Medicare referral process.
Chapter 6 - Client Responsibilities
Adds information regarding a MSP client’s requirement to apply for other benefits.
Updates information related to the All or Nothing Rule and application signatures.
Updates information related to the All or Nothing Rule and renewal signatures.
Chapter 10 - Social Security Numbers
Provides clarification on how a revision to the HCAPP affects Social Security Number (SSN) requirements.
Chapter 11 - Citizenship and Immigration Status
Provides clarification on how a revision to the HCAPP affects verification of identity.
Chapter 15 - Third Party Liability (TPL)
Adds information regarding eligibility for TRICARE for Life coverage.
Incorporates Bulletin #11-21-10 and revises information related to the verification of burial assets, excluded or unavailable assets, and unchanging assets.
Incorporates Bulletin #11-21-11.
Chapter 21 - Income Calculation
Incorporates Bulletin #11-21-11.
Chapter 22 - Standards and Guidelines
Includes annual updates to applicable standards and guidelines that are effective January 1, 2012.
Chapter 29 - Quality Assurance
Updates procedural information related to discrepancies found by the Income and Eligibility Verification System (IEVS).
Contains two new terms.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.10 - MA Bases of Eligibility.
Adds information that adults can have an MA basis of eligibility as an adult without children.
l Section 03.35 - Medicare Savings Programs (MSP)
Adds a related topics link to Section 06.15, Applying for Other Benefits, which includes new information regarding an MSP client's requirement to apply for other benefits.
Chapter 4 - Social Security Administration (SSA) Benefits
l Section 04.40.10 - Medicare Part B.
Updates the reductions in Medicare Part B premiums effective January 1, 2012, from applicable Medicare Advantage Plans.
l Section 04.40.20.05 - Medicare Part D Benchmark Plans.
Updates information to clarify which Medicare Part D plans will be benchmark plans in 2012 and which plans will no longer be benchmark plans in 2012.
l Section 04.45.05 - Medicare Part D and Minnesota Health Care Programs (MHCP).
Adds a link to the new "2012 Amounts in Excess of the Benchmark to Apply as Medical Expense" document.
l Section 04.45.10 - Referrals to Medicare.
Clarifies that a person previously enrolled on Medicare may still need a Medicare referral if their Medicare eligibility ended for any reason other than non-payment of a premium; provides instructions for workers to also review the RMSC screen in the Medicaid Management Information System (MMIS) for Centers for Medicare and Medicaid Services (CMS) alias information to ensure that there is no discrepancy in a client’s name or date of birth; and clarifies that retroactive Service Limited Medicare Beneficiary (SLMB) may be approved for some MSP clients if they received a Medicare Buy-in Referral Letter (DHS-3439) asserting that MSP would be approved for a date that is now in the past due to a delay in the client's ability to meet with the SSA.
Chapter 6 - Client Responsibilities
l Section 06.15 - Applying for Other Benefits.
Adds information that MSP clients do not need to apply for other benefits if those other benefits do not affect eligibility. Additionally, instructs workers to review Section 04.45.10, Referrals to Medicare, before requiring MinnesotaCare clients who appear to eligible for Medicare Part A or Part B to apply for those programs.
l Section 07.15.05 - Application Signature.
Updates information to remove a reference to the All or Nothing Rule, which no longer applies to the signature requirement for MinnesotaCare applications.
l Section 08.15 - Renewal Signature.
Updates information to remove a reference to the All or Nothing Rule, which no longer applies to the signature requirement for MinnesotaCare renewals.
Chapter 10 - Social Security Number (SSN)
l Section 10 - Social Security Number.
Adds clarification that the revised HCAPP now requests the SSN of all household members for the purpose of verifying income, but only applying household members are required to provide their SSN.
Chapter 11 - Citizenship and Immigration Status
l Section 11.05.05 - Sources of Citizenship and Identity Verification.
Removes language that allowed the signature of a parent, guardian, or caretaker on the HCAPP to act as an affidavit for the verification of the identity of a child who was under age 16.
Chapter 15 - Third Party Liability (TPL)
l Section 15.30 - TRICARE and CHAMPVA.
Adds information to indicate that a person must be enrolled in both Medicare Part A and Part B to qualify for TRICARE for Life.
l Section 19.15 - Availability of Assets.
Adds clarification that verification of an excluded or unavailable asset should not be requested from a client unless there has been a change anticipated in the asset.
l Section 19.20 - Verification of Assets.
Adds clarification for MinnesotaCare and MA Method A that approval for children should not be held up for a parent’s asset verification. Additionally, updates information for MA Method A and Method B to clarify that duplicate verification is not required of an excluded or unchanging asset at renewal if the client has already provided verification of that asset at any time in the past.
l Section 19.25.40.10 - Verification of Burial Assets and Life Insurance.
Revises instruction to workers to verify all burial assets at application and when there has been a change in the asset to determine if the burial asset is counted, excluded, or unavailable.
l Section 19.40.35 - Imposing a Transfer Penalty.
Removes information related to transferred assets that are returned completely or partially, and added a link to the new manual section solely dedicated to that subject.
l Section 19.40.45 - Ending a Transfer Penalty (new).
Incorporates Bulletin #11-21-10 by clarifying when it is applicable to end a transfer penalty, including when the transfer penalty is the result of a non-action or the result of a transferred asset.
l Section 20.10 - Verification of Income.
Incorporates Bulletin #11-21-11 by clarifying that verification of farm depreciation is not required for MinnesotaCare farm self-employment.
l Section 20.25.20.05 - MinnesotaCare Self-Employment Income.
Incorporates Bulletin #11-21-11 by removing references to tax forms and schedules that are no longer required to calculate MinnesotaCare farm self-employment income.
Chapter 21 - Income Calculation (Community)
l Section 21.10.05 - MinnesotaCare Income Calculation.
Incorporates Bulletin #11-21-11 by clarifying that farm depreciation no longer needs to be added when calculating the MinnesotaCare household income.
l Section 21.50.15.05 - Pickle Disregard COLA Chart.
Updates the Pickle Disregard COLA Chart with amounts effective January 1, 2012.
l Section 21.50.40 - Blind or Disabled Student Child Disregard.
Updates the Blind or Disabled Student Child Disregard limit effective January 1, 2012.
Chapter 22 - Standards and Guidelines
l Section 22.10 - Special Income Standard (SIS).
Updates the Special Income Standard income limit effective January 1, 2012.
l Section 22.25 - Roomer/Boarder Standard Amount
Removes the information table and reorganizes the roomer/boarder standard amounts with bullets because the amounts will remain as is with no annual update.
l Section 22.40 - Minimum/Maximum Asset Allowance.
Updates the minimum and maximum asset allowance effective January 1, 2012.
l Section 22.45 - Long-Term Care (LTC) Allowance.
Updates the clothing and personal needs allowance and the maximum monthly income allowance effective January 1, 2012.
l Section 22.50 - Remedial Care Expense.
Updates the remedial care expense amount that is effective January 1, 2012, through June 30, 2012.
l Section 22.55 - Medicare Cost Sharing Amounts.
Updates the Medicare cost sharing amounts effective January 1, 2012, and adds information that MA enrollees who receive Home and Community Based Services (HCBS) are exempt from paying a Medicare Part D copayment.
l Section 22.65 - Home Equity Limit.
Updates the home equity limit effective January 1, 2012.
Chapter 29 - Quality Assurance
l Section 29.05.20 - Processing IEVS Matches.
Aligns policy with the POLI/TEMP manual by removing language that instructed workers to resolve IEVS discrepancies using the PF11 button in MAXIS.
l Transferee (new).
l Transferor (new).