This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective December 1, 2013.
This manual letter adds information regarding mandatory annuity withdrawals, updates information about Emergency Medical Assistance (EMA), revises information about voluntary enrollment in Special Needs Basic Care (SNBC) and provides annual updates effective as of January 1, 2014.
Manual Letter #64 also includes the publication of the "2014 Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense” document. The document is accessible from the HCPM home page.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Updates information about EMA and revises information about voluntary enrollment for SNBC.
Chapter 4 - Social Security Administration (SSA) Benefits
Provides annual updates to Supplemental Security Income (SSI) payment amounts, reductions in Medical Part B premiums by Medicare Advantage Plans and Medicare Part D benchmark plans.
Adds information about mandatory withdrawals from an annuity. Also, updates a question in the Home Equity Limit Analysis.
Chapter 21 - Income Calculation (Community)
Provides annual updates to the pickle disregard cost of living adjustment (COLA) chart and the blind or disabled student disregard limit.
Chapter 22 - Standards and Guidelines
Provides annual updates to the Special Income Standard (SIS) gross monthly income limit, minimum and maximum asset allowances, long-term care allowances, remedial care expense amount, Medicare cost sharing amounts and home equity limit.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Section 03.30.10 - Medical Assistance for People With Blindness
In the "Service Delivery" section, removes Clearwater, Beltrami, and Hubbard counties from the list of counties in which eligible residents cannot voluntarily enroll in SNBC. Cook, Itasca, Kittson, Marshall, Pennington, Red Lake, Roseau and Swift counties were added to the list.
Section 03.30.15 - Medical Assistance for People With a Disability
In the "Service Delivery" section, removes Clearwater, Beltrami, and Hubbard counties from the list of counties in which eligible residents cannot voluntarily enroll in SNBC. Cook, Itasca, Kittson, Marshall, Pennington, Red Lake, Roseau and Swift counties were added to the list.
Section 03.45.05 - Emergency Medical Assistance
Changes to this section include:
n In the introductory section of the page, text referencing a long-term care service through one of the home and community-based waiver services is replaced by text referencing other services covered by basic MA.
n In the "Renewals" section, updates policy to indicate that EMA coverage follows standard MA guidelines for renewal of eligibility. EMA will remain open for labor and delivery.
n In the "Verifications" section, the following text is removed:
m An instruction for workers to verify the dates of medical services and open EMA only from the date the medical emergency begins until the medical emergency ends for a sudden onset of an emergency medical condition that causes acute symptom
m A statement indicating that DHS’s medical review agent will contact the MMIS User Services Help Desk upon a decision to authorize care beyond the emergency room or hospital
m A statement indicating that MMIS User Services Help Desk staff will contact the client’s worker who will continue EMA for the client for the authorized time frame or until the next annual renewal
m A statement indicating that if further services are needed the care plan certification request needs to be submitted and authorized at least annually.
The following text replaces the deleted text: "When there is a care plan certification request the client and the physician submitting the DHS-3642 are notified if services beyond the emergency room have been approved. Only request verification of the approval at renewal.”
n In the "End of Eligibility in Basis" section, additional text clarifies that EMA is available for the duration of the medical emergency or until the next renewal whichever is later.
Chapter 4 - Social Security Administration (SSA) Benefits
Section 04.15 - Supplemental Security Income (SSI)
Adds the maximum SSI payment amounts effective January 1, 2014.
Section 04.40.10 - Medicare Part B
Updates the list of Medicare Advantage plans that subsidize Medicare Part B premiums and the reductions in premiums, if any, provided by those plans beginning January 1, 2014.
Section 04.40.20.05 - Medicare Part D Benchmark Plans
Updates information about which Medicare Part D plans will be stand alone benchmark plans in 2014. The revision also clarifies which 2013 stand alone benchmark plans will no longer be stand alone benchmark plans in 2014.
Section 04.45.05 - Medicare Part D and Minnesota Health Care Programs (MHCP)
Adds a link to the new "2014 amounts in Excess of the Benchmark to Apply as Medical Expense” document.
Section 19.25.30 - Annuities
Changes to this section include:
n In the "Counting Annuities as Income” section, explains that there are times an owner of an annuity is required to make mandatory minimum withdrawals during the accumulation phase of an annuity. These withdrawals are age-dependent and usually occur when the owner is 59 and a half or 70 and a half.
n In the "Annuity Verification” section, adds as a reason to request verification if it is unclear a payment from an annuity is received due to annuitization or a mandatory withdrawal due to age.
Section 19.55.05 - Home Equity Limit Analysis
Updates question #6 of the Home Equity Limit Analysis to reflect the new Home Equity Limit effective January 1, 2014.
Chapter 21 - Income Calculation (Community)
Section 21.50.15.05 - Pickle Disregard COLA Chart
Updates the pickle disregard COLA chart with the new Retired, Survivors, and Disabled Insurance (RSDI) COLA of 1.5% effective as of January 1, 2014.
Section 21.50.40 - Blind or Disabled Student Child Disregard
Updates the blind or disabled student child disregard limit effective January 1, 2014.
Chapter 22 - Standards and Guidelines
Section 22.10 - Special Income Standard (SIS)
Adds the SIS gross monthly income limit effective January 1, 2014.
Section 22.40 - Minimum/Maximum Asset Allowance
Adds the minimum and maximum asset allowance effective January 1, 2014.
Section 22.45 - Long-Term Care (LTC) Allowances
Adds the clothing and personal needs allowance and the maximum monthly income allowance effective January 1, 2014.
Section 22.50 - Remedial Care Expense
Adds the remedial care expense amount effective January 1, 2014, through June 30, 2014.
Section 22.55 - Medicare Cost Sharing Amounts
Adds Medicare cost sharing amounts effective January 1, 2014.
Section 22.65 - Home Equity Limit
Adds the home equity limit effective January 1, 2014.