This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective March 1, 2013.
Manual Letter #59 incorporates the remaining portion of Bulletin #12-21-02, "Legislative changes for Noncitizen Medical Assistance (NMED)."
This manual letter also includes policy clarification regarding Medical Assistance (MA) eligibility for clients who are undocumented or have a temporary nonimmigrant status and removes references to two obsolete forms.
Chapter 2 - Minnesota Health Care Programs
Incorporates Bulletin #12-21-02 and adds information about CHIP-funded MA for pregnant women.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Clarifies policy related to clients who are undocumented or have a temporary immigration status. The changes in this chapter also revise policy regarding cost effective insurance. Additional updates remove reference to obsolete form DHS-4599, Request for Information from Parents Asking If Their Infant Has Access to Other Health Insurance and About Available Insurance for That Infant.
Chapter 11 -Citizenship and Immigration Status
Clarifies policy related to clients who are undocumented or have a temporary immigration status.
Chapter 15 - Third Party Liability (TPL)
Removes a reference to obsolete form DHS-4599, and form DHS-4870, MinnesotaCare Accident/Injury Follow-up Request for Information.
Provides information about obsolete forms, DHS-4599 and DHS-4870.
Chapter 2 - Minnesota Health Care Programs
l Section 02.05 - Hierarchy of Health Care Programs
Incorporates Bulletin #12-21-02 by clarifying that NMED is a state-funded program providing all MA-covered services for people receiving services from the Centers for Victims of Torture (CVT). This change also removes reference to NMED eligibility for clients who do not meet immigration status requirements for federally funded MA.
The update to this section includes the addition of information relating to CHIP-funded MA for pregnant women who are ineligible for federally funded MA due solely to their immigration status.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.25.05 - Medical Assistance (MA) for Pregnant Women
Clarifies that pregnant women who are undocumented or have a nonimmigrant status must be evaluated for eligibility using a pregnant basis of eligibility and meet all other MA eligibility requirements, including state residency, to qualify for CHIP-funded MA.
Adds that additional information should be requested if information provided on an application is inconsistent with other information provided by a client.
An additional change to this section removes the statement that health care policies that cover a pregnant woman’s maternity care are considered cost effective by the Benefit Recovery Section (BRS) and do not require further review. All health care policies must be evaluated in the same manner for cost effectiveness. Refer to Section 15.10.05.05 - Determining Cost Effectiveness for more information.
l Section 03.25.10 - Medical Assistance (MA) for Auto Newborns
Removes reference to DHS-4599 because the form has been made obsolete. In its place, adds a reference to DHS-3271, Request for Information.
l Section 03.25.15 - Medical Assistance (MA) for Children Under 21
Removes reference to DHS-4599 because the form has been made obsolete. In its place, adds a reference to DHS-3271.
l Section 03.30.25 - TEFRA Option
Removes statement that health care policies covering TEFRA enrollees are considered cost effective by BRS and do not require further review if the child’s portion of the premium is $50 or less per month. The statement is replaced by instruction to follow standard MA guidelines. All health care policies must be evaluated in the same manner for cost effectiveness. Refer to Section 15.10.05.05 - Determining Cost Effectiveness for more information.
Chapter 11 - Citizenship and Immigration Status
l Section 11.30.10 - Undocumented and Nonimmigrant People
Clarifies that clients with an undocumented or temporary immigration status must have an MA basis of eligibility and meet all other eligibility requirements, including state residency, to qualify for CHIP-funded MA, state-funded Medical Assistance (NMED) or Emergency Medical Assistance (EMA).
Also adds that additional information should be requested if information provided on an application is inconsistent with other information provided by a client.
Chapter 15 - Third Party Liability (TPL)
l Section 15.10 - Other Health Care Coverage - MA
Removes reference to DHS-4599 because this form has been made obsolete. In its place, adds a reference to DHS-3271, Request for Information.
l Section 15.15 - Non-Health Care Coverage Third Party Liability (TPL)
Removes reference to DHS-4870 because this form has been made obsolete. If necessary, use DHS-3271 to request required information.
Also removes the MAXIS email address previously used by MinnesotaCare to notify BRS of potential TPL. Notify BRS of potential TPL by sending SIR webmail to HCOBRS-Health@CO.DHS.state.mn.us.
l DHS-4599 - Request for Information From Parents Asking If Their Infant Has Access to Other Health Insurance and About Available Insurance for That Infant.
With the publication of Manual Letter #59, DHS-4599 is obsolete. When sending DHS-1922B, Health Insurance Information Form, use DHS-3271 in place of DHS-4599.
l DHS-4870 - MinnesotaCare Accident/Injury Follow-up Request for Information
With the publication of Manual Letter #59, DHS-4870 is also obsolete. If necessary, use DHS-3271 to request required information.
.