This manual letter lists new and revised material for the Health Care Programs Manual. Unless otherwise noted, new and revised instructions are effective May 1, 2013.
Manual Letter #61 incorporates Bulletin #13-21-01, "2012 Legislative Changes for Medical Assistance for Employed Persons With Disabilities (MA-EPD) Program Enrollees."
This manual letter also includes annual changes to standards and guidelines that are effective July 1, 2013. Begin using these new amounts when determining eligibility for July 1, 2013, and beyond. Current standards and guidelines effective through June 30, 2013, remain on the updated sections.
Additionally, Manual Letter #61 includes updates related to Noncitizens Medical Assistance (NMED), Emergency Medical Assistance (EMA), access services, disability certification and liens and benefit recovery.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Incorporates Bulletin #13-21-01.
Updates procedure for transferring applications.
Chapter 11 - Citizenship and Immigration Status
Clarifies information about NMED and EMA.
Chapter 12 - Certification of Disability
Clarifies information regarding disability determinations and MA-EPD.
Chapter 18 - Deeming Income and Assets
Incorporates Bulletin #13-21-01.
Incorporates Bulletin #13-21-01 and adds update regarding liens and benefit recovery.
Chapter 22 - Standards and Guidelines
Adds annual changes to standards and guidelines that are effective July 1, 2013.
Adds information about new form, County to MinnesotaCare Transfer Form (DHS-6670).
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.30.20 - Medical Assistance for Employed Persons With Disabilities (MA-EPD)
Incorporates Bulletin #13-21-01 by removing the age limitation for MA-EPD. Clients can be of any age to qualify for MA-EPD as long as the person was certified disabled by SSA or SMRT before the age of 65.
Incorporation of Bulletin #13-21-01 also includes clarification that some MA-EPD income and asset rules continue to apply in basic MA determinations for MA-EPD clients, age 65 or older, who lose eligibility for MA-EPD and were enrolled during each of the 24 consecutive months before the month in which the client turns age 65. Specifically, continue to exclude the income and assets of a spouse for clients who meet this criteria. As it relates to assets, apply the MA-EPD asset limit, disregards and exclusions. Do not require an asset assessment if a client is requesting MA payment of long-term care (LTC) services because they are residing in a LTC facility or requesting services through the Elderly Waiver (EW). These MA-EPD policies also apply in basic MA determinations for MA-EPD clients who turn 65 in either 2012 or 2013 and are enrolled in MA-EPD for 20 months of the 24 consecutive months before the month in which the client turns age 65.
Additionally, the changes to this section incorporate Bulletin #13-21-01 by clarifying that MA-EPD clients age 65 or older are not excluded from managed care and must be enrolled into a managed care plan when they turn 65. Workers are also instructed to use household composition rules for EW for MA-EPD clients receiving services through EW.
l Section 03.40.25 - Elderly Waiver (EW)
Incorporates Bulletin #13-21-01 by clarifying that clients who remain eligible for and enrolled in MA-EPD while on EW are subject to MA-EPD guidelines for assets, budgeting and monthly premium.
l Section 07.20.45 - How to Transfer and Receive an Application
Introduces the new County to MinnesotaCare Case Transfer Form (DHS-6670) to be used by county and tribal agencies when transferring a case to MinnesotaCare Operations. Also clarifies that transfers to MinnesotaCare need to include information about employer-subsidized insurance.
The revisions to this section also indicate that transfers should include results obtained from the Systematic Alien Verification for Entitlements (SAVE) system, current health insurance information and citizenship and identity verifications, unless verified through SSA. Workers are also instructed not to include old applications and other items that are not required by the other program.
Chapter 11 - Citizenship and Immigration Status
l Section 11.15 - Funding Health Care for Noncitizens
Clarifies that a noncitizen who meets all other eligibility requirements for MA but does not have an immigration status that qualifies for MA with FFP must be receiving services through the Center for Victims of Torture (CVT) to be eligible for NMED.
Also, removes language that no longer applies to EMA eligibility for noncitizens. The policy now simply states that noncitizens who are ineligible for MA with FFP due to immigration status, date of entry or sponsor deeming may be eligible for EMA if they have a medical emergency.
Chapter 12 - Certification of Disability
l Section 12 - Certification of Disability
Clarifies that people age 65 or older who apply for MA-EPD must have been certified disabled prior to age 65 to qualify.
Chapter 18 - Deeming Income and Assets
l Section 18 - Deeming Income and Assets
Incorporates Bulletin #13-21-01 by clarifying that a spouse’s income and assets are not deemed for MA if the client was on MA-EPD for 24 consecutive months before the month in which the client turns age 65. This also applies to clients who turn 65 in 2012 or 2013 and who were on MA-EPD for 20 months of the 24 consecutive months prior to the month in which the client turns age 65.
l Section 19.45 - Asset Assessments
Incorporates Bulletin #13-21-01 by clarifying that an asset assessment is not required for married clients on MA-EPD who request MA payment of LTC services through EW.
Also removes a reference to the 60-day time frame for long-term care consultations (LTCC).
l 19.50 - Liens and Estate Recovery
Adds rules for estate recovery and liens for the General Assistance Medical Assistance (GAMC) program. This information was previously removed when GAMC ended. The information remains relevant because the state continues to recover benefits from the estates of deceased clients who were enrolled in GAMC.
l Section 19.50.05 - Methods of Estate Recovery
Adds references to GAMC in the sections relating to Probate Estate, Issuances of a Certificate of Clearances for Medical Assistance Claim and Affidavit of Collection of Personal Property.
Chapter 22 - Standards and Guidelines
l Section 22.05.05 - 75 Percent of FPG
Adds the 75% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.10 - 100 Percent of FPG
Adds the 100% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.15 - 120 Percent of FPG
Adds the 120% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.20 - 135 Percent of FPG
Adds the 135% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.25 - 150 Percent of FPG
Adds the 150% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.30 - 175 Percent of FPG
Adds the 175% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.35 - 185 Percent of FPG
Adds the 185% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.40 - 200 Percent of FPG
Adds the 200% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.45 - 215 Percent of FPG
Adds the 215% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.50 - 250 Percent of FPG
Adds the 250% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l ection 22.05.55 - 275 Percent of FPG
Adds the 275% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.05.60 - 280 Percent of FPG
Adds the 280% FPG income standards effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.20.05 - MinnesotaCare for Volunteer Firefighters and Ambulance Attendants Premium
Adds the new premium that will be issued to enrollees of MinnesotaCare for Volunteer Firefighters and Ambulance Attendants (MVFAA) during the period of July 1, 2013, through June 30, 2014.
l Section 22.35 - SAPSNF
Adds the new Statewide Average Payment for Skilled Nursing Facility (SAPSNF) care amount effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.45 - Long-Term Care (LTC) Allowances
Adds the new amounts for the home maintenance allowance, the maintenance needs allowance, basic shelter allowance and minimum monthly income allowance. These new figures are effective for the period of July 1, 2013, through June 30, 2014.
l Section 22.50 - Remedial Care Expense
Adds the new remedial care expense effective for the period of July 1, 2013, through December 31, 2013.
l County to MinnesotaCare Case Transfer Form (DHS-6670)
Counties and tribal agencies must use this new form to transfer a case to MinnesotaCare Operations.