This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective November 1, 2012.
This manual letter incorporates Bulletin #12-21-10, "Legislative Changes to MinnesotaCare Effective July 1, 2012,” and Bulletin #12-21-11, "Legislative Changes to MinnesotaCare Effective July 1, 2012."
Manual Letter #55 also includes updates related to Noncitizens Medical Assistance (NMED), Emergency Medical Assistance (EMA), excluded time services, and noncitizens granted deferred action under the Deferred Action for Childhood Arrivals (DACA) process.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Incorporates Bulletins #12-21-10 and #12-21-11. Also, updates information about NMED and EMA.
Incorporates Bulletins #12-21-10 and #12-21-11.
Incorporates Bulletin #12-21-11.
Chapter 9 - Verification Requirements
Incorporates Bulletin #12-21-11.
Chapter 11 - Citizenship and Immigration Status
Provides eligibility information about noncitizens who have been granted deferred action under the DACA process.
Chapter 13 - State and County Residence
Updates information about excluded time services.
Chapter 15 - Third Party Liability
Incorporates Bulletin #12-21-11.
Chapter 17 - Household Composition
Incorporates Bulletin #12-21-11.
Incorporates Bulletin #12-21-11.
Chapter 21 - Income Calculation (Community)
Incorporates Bulletin #12-21-11.
Chapter 24 - Medical Spenddowns
Incorporates Bulletin #12-21-10 and updates information about M bills.
Incorporates Bulletins #12-21-10 and #12-21-11.
Incorporates Bulletin #12-21-10.
Incorporates Bulletin #12-21-11 by adding three new forms.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.05.05 - Change in MinnesotaCare Eligibility
Incorporates Bulletin #12-21-11 by adding termination from foster care or release from a juvenile residential correctional facility in which an enrollee resided on his or her 18th birthday as type of change that may affect his or her eligibility.
l Section 03.10 - Medical Assistance (MA) Bases of Eligibility
Clarifies that Noncitizen Medical Assistance (NMED) is limited to noncitizens receiving services through the Center for Victims of Torture (CVT). Also, updates an example to illustrate that adults without children who have a medical emergency can be eligible for Emergency Medical Assistance (EMA) as they now have an MA basis of eligibility.
l Section 03.20.15 - MinnesotaCare for Children Under 21
Incorporates Bulletin #12-21-10 by clarifying that children with household income equal to or less than 200% FPG are not assessed a monthly premium. The changes to this section also add that children with household income greater than 200% FPG, but equal to or less than 275% FPG are subject to the sliding scale premiums.
Incorporates Bulletin #12-21-11 by adding a reference and link to the new HCPM Section 03.20.35 - MinnesotaCare for Certain Children Exiting Foster Care or a Residential Juvenile Facility.
l Section 03.20.35 - MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility (new)
This new manual section incorporates Bulletin #12-21-11 by providing MinnesotaCare eligibility requirements for children who exit foster care or are released from a juvenile residential correctional facility in which they resided on their 18th birthday.
l Section 03.25.20 - Foster Care
Incorporates Bulletin #12-21-11 by clarifying that children residing in foster care or a juvenile residential correctional facility on their 18th birthday qualify for MinnesotaCare upon exiting care without regard to income, other health care coverage barriers, All or Nothing Rule, premium payments, or annual renewals. Workers are instructed to determine MinnesotaCare eligibility for these children or transfer the case to MinnesotaCare if they lose MA eligibility for reasons other than state residency.
l Section 03.45.05 - Emergency Medical Assistance (EMA)
Adds noncitizens granted deferred action under the Deferred Action for Childhood Arrivals (DACA) process to the list of people that may qualify for Emergency Medical Assistance (EMA).
l Section 07.05.05 - Applications for Minnesota Health Care Programs
Incorporates Bulletin #12-21-11 by adding information about the Request for MinnesotaCare (DHS-6179) form, which can be used by children residing in foster care or a juvenile residential correctional facility on their 18th birthday to apply for MinnesotaCare upon their release from care. Additionally, clarifies that clients not fitting this description cannot use the Request for MinnesotaCare to apply for MinnesotaCare coverage.
l Section 07.05.10 - Application Required
Incorporates Bulletin #12-21-11 by clarifying that children previously enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility are not required to complete an application to apply for MinnesotaCare, even if the last application on file is older than 11 months.
l Section 07.05.15 - Application Not Required
Incorporates Bulletin #12-21-11 by clarifying that children who resided in foster care or a residential juvenile facility on their 18th birthday and have been released from care are not required to complete an application to apply for MinnesotaCare, even if the original application on file is older than 11 months. These children must be evaluated for MinnesotaCare eligibility upon termination from MA or transferred to the appropriate agency for a MinnesotaCare eligibility determination.
l Section 07.20.25 - Eligibility Begin Date
Incorporates Bulletin #12-21-11 by clarifying that the MinnesotaCare eligibility begin date for children who were residing in foster care or a juvenile residential correctional facility on their 18th birthday and have been released from care is the first day of the month after release.
l Section 07.20.30 - Retroactive MinnesotaCare
Incorporates Bulletin #12-21-10 by clarifying that children with household income equal to or less than 200% FPG are not required to pay premium for retroactive coverage beginning July 1, 2012.
l Section 07.30 - Case Notes
Incorporates Bulletin #12-21-11 by instructing workers to use a specific header in case notes to denote the case is that of a child who qualifies for MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility.
l Section 08.05 - Annual Renewal Exemptions
Incorporates Bulletin #12-21-11 by adding children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to the list of MinnesotaCare enrollees exempt from annual renewal requirements.
l Section 08.10 - Renewal Forms
Incorporates Bulletin #12-21-11 by adding MinnesotaCare Continued Coverage (DHS-6179B) to the list of forms that may be used during the renewal process. This form may be sent to children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to determine if the enrollee still lives in Minnesota and wishes to continue coverage. The form is only optional because the information may be alternatively obtained by phone call or other means. Enrollees who are sent the form are not required to return it if they still reside in Minnesota and wish to continue coverage.
Chapter 9 - Verification Requirements
l Section 09.05 - Mandatory Verifications
Incorporates Bulletin #12-21-11 by clarifying that income, employer-subsidized insurance (ESI), and pregnancy verifications are not required for children applying for or enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility.
Chapter 11 - Citizenship and Immigration Status
l Section 11.25.25 - Other Lawfully Present Noncitizens
Clarifies that noncitizens granted deferred action under the Deferred Action for Childhood Arrivals (DACA) process are not eligible for state or federally funded MA or MinnesotaCare. These noncitizens are not considered lawfully residing in the United State because deferred action in this circumstance does not confer a lawful status. EMA may be considered for these clients if a medical emergency exists.
Chapter 13 - State and County Residence
l Section 13.25.05 - Excluded Time
Removes receipt of Personal Care Assistant (PCA) services paid by MA as a service eligible for excluded time. Additionally, updates an example relating to excluded time that included a reference to PCA services paid by MA. The example now uses day training and habilitation programs to illustrate excluded time services policy.
Chapter 15 - Third Party Liability (TPL)
l Section 15.05 - MinnesotaCare Other Health Care Coverage Barriers
Incorporates Bulletin #12-21-11 by adding applicants and enrollees of MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to the list of persons who meet an exception to MinnesotaCare other health care coverage barriers.
Chapter 17 - Household Composition
l Section 17.10 - Determining Household Size for MinnesotaCare
Incorporates Bulletin #12-21-11 by clarifying that a child applying for or enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility can only be considered a household size of one. Family members living with the child cannot be counted in the child’s MinnesotaCare household size. The child, however, may be included as a household member when determining MinnesotaCare eligibility for other family members. An example is added to illustrate this policy.
l Section 20.10 - Verification of Income
Incorporates Bulletin #12-21-11 by clarifying that income verification is not required for children who are applying for or are enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility.
l Section 20.15 - No Income Reported
Incorporates Bulletin #12-21-11 by clarifying that children who are applying for or enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility are not required to report income. Workers are instructed to exclude all earned and unearned income received by these children.
l Section 20.25.45 - Child Income
Incorporates Bulletin #12-21-11 by clarifying that the earned and unearned income of a child applying for or enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility should be excluded. Workers are instructed to follow standard MinnesotaCare policy to determine whether the child’s income should be counted when determining the eligibility of other household members in whose household the child is a member.
Chapter 21 - Income Calculation (Community)
l Section 21 - Income Calculation (Community)
Incorporates Bulletin #12-21-10 by clarifying that the 200% income guideline is also used to determine if children are subject to a zero premium or a sliding scale premium. Children with household income greater than 275% FPG are subject to the maximum premium. Also, adds that the 75% income guideline is used to determine possible eligibility for MA for adults without children.
Chapter 24 - Medical Spenddowns
l Section 24.15.20 - M Bills
Updates information to indicate M bills are applied to a spenddown after H bills and before P bills.
l Section 24.15.35 - MinnesotaCare Expenses
Incorporates Bulletin #12-21-10 by clarifying that children in households with income equal to or less than 200% FPG do not have a monthly premium that can be applied as an expense to meet an MA spenddown.
Also, updates the groups of MinnesotaCare enrollees for which DHS receives state funding.
l Section 25.05 - MinnesotaCare Premiums
Incorporates Bulletin #12-21-10 by adding children with household income equal to or less than 200% FPG to the list of people exempt from paying monthly premiums. Also, removes information about fixed premiums for children with household income equal to or less than 150% FPG and replaces it with information about zero premiums for children with household income equal to or less than 200% FPG.
Incorporates Bulletin #12-21-11 by adding children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to the list of people exempt from paying monthly premiums.
l Section 25.05.05 - Initial, Ongoing and Changes to Premiums
Incorporates Bulletin #12-21-10 and Bulletin #12-21-11 by clarifying that children with household income equal to or less than 200% FPG and children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility are exempt from paying a monthly premium. Also, adds children with household income equal to or less than 200% FPG to the list of enrollees whose coverage cannot be closed as a result of nonpayment of the monthly premium.
l Section 25.05.15 - MinnesotaCare Reinstatement
Incorporates Bulletin #12-21-11 by adding a reference and link to new HCPM Section 03.20.35, MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility, for more information about reinstating MinnesotaCare coverage for clients enrolled under this provision.
l Section 25.05.20 - Four Month Penalty
Incorporates Bulletin #12-21-10 by clarifying that children with household income equal to or less than 200% FPG are not subject to a four-month penalty if the household does not pay the monthly premium for the adults enrolled on the case. Two examples were updated to reflect this change in policy.
Incorporates Bulletin #12-21-11 by adding that children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility are not subject to the four-month penalty if they choose to voluntarily terminate coverage.
l Section 26 - Notices
Incorporates Bulletin #12-21-11 by adding instruction to send MinnesotaCare Approval (DHS-6179A) when a child is approved for MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility. The form provides the child his or her eligibility begin date, the date of enrollment into a health plan, and fee-for-service coverage dates, if applicable.
l DHS-6179 - Request for MinnesotaCare (new)
This new form is an application that can be used by children residing in foster care or a juvenile residential correctional facility on their 18th birthday to apply for MinnesotaCare upon their release from care. Clients who do not fit this description cannot use the form to apply for MinnesotaCare.
l DHS-6179A - MinnesotaCare Approval Letter (new)
This new form is manually sent to children who qualify for MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility. The form provides these enrollees their eligibility begin date, the date of enrollment into a health plan, and dates of fee-for-service coverage, if applicable.
l DHS-6179B - MinnesotaCare Continued Coverage (new)
This new form may be sent annually to children enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility to determine if he or she still lives in Minnesota and wishes to continue coverage. These enrollees are not required to return the form if they still live in the state and want to continue MinnesotaCare coverage. Sending the form is not required. The information may be alternatively obtained by phone or other means.