This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective June 1, 2014.
Manual Letter #67 changes how federal poverty guidelines (FPG) are provided in the HCPM. Previously, the HCPM included a section for each FPG standard that affected eligibility for a Minnesota Health Care Program. Each section provided the equivalent dollar amounts for the FPG standard along with information about which health care programs were affected by the standard. These sections are now archived. The FPG standards previously included in these sections are available on Insurance Affordability Programs (IAPs) Income and Asset Guidelines (DHS-3461A). The HCPM links to DHS-3461A when referring to a FPG standard. The only exception is 185% FPG, which is not included on DHS-3461A. The equivalent dollar amounts for this FPG standard is incorporated into HCPM Section 03.25.35 - Transitional Medical Assistance (TMA) and Transition Year Medical Assistance (TYMA) because it specifically applies to eligibility for the second six-month period of TYMA.
This manual letter also provides annual changes effective July 1, 2014.
Additional updates in this manual letter include changes related to TMA and TYMA, Medicare and MinnesotaCare, and medical spenddowns.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Updates information relating to TMA and TYMA.
Chapter 4 - Social Security Administration (SSA) Benefits
Removes information about Medicare and MinnesotaCare.
Updates the parental fee computation steps and schedule information.
Chapter 22 - Standards and Guidelines
Reorganizes Section 22.05 and archives its subsections. The changes to this section also includes annual changes.
Chapter 23 - Medical Assistance (MA) Payment of Long-Term Care (LTC) Services
Updates information in the provided examples.
Chapter 24 - Medical Spenddowns
Updates spenddown information.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.25.35 - Transitional MA / Transition Year MA (TMA/TYMA)
Adds the FPG chart for 185% FPG.
Regarding the end of TMA and TYMA eligibility, updates instructions to send affected enrollees Minnesota Application for Health Coverage and Help Paying Costs (DHS-6696).
l Section 03.25.35.10 - Concurrent Eligibility for TMA and TYMA
Updates information about concurrent eligibility under Method A and TMA/TYMA to include parents and relative caretakers.
Chapter 4 - Social Security Administration (SSA) Benefits
l Section 04.45 - Medicare and Minnesota Health Care Programs (MHCP)
Removes references to MinnesotaCare. Information about Medicare as it relates to MinnesotaCare can be found in Insurance Affordability Programs Manual (IAPM) Section 500.10.20 - Minimum Essential Coverage for MinnesotaCare.
l Section 16.20.10 - Computation of Parental Fees
Updates Step 4 of the computation instructions to compare the result to 275% FPG for the appropriate household size.
The parental fee schedule is also updated to reflect the percentages and FPG standards effective as of July 1, 2014.
Chapter 21 - Income Calculation (Community)
l Section 21 - Income Calculation (Community)
Removes references to MinnesotaCare. Information about MinnesotaCare income can be found in IAPM Section 500.15.05.05 - MinnesotaCare Income Methodology.
Chapter 22 - Standards and Guidelines
l Section 22.05 - Federal Poverty Guidelines
This section is reorganized to reference current FPG standards and the programs to which they apply. Adds instructions to refer to DHS-3461A for specific dollar amounts for the FPG standards.
Links to the IAPM are provided for FPG standards for MA for Families With Children and Adults and MinnesotaCare.
l Section 22.35 - SAPSNF
Adds the Statewide Average Payment for Skilled Nursing Facility (SAPSNF) amount effective July 1, 2014, through June 30, 2015.
l Section 22.45 - Long-Term Care (LTC) Allowances
Adds the amount effective July 1, 2014, through June 30, 2014, for the Home Maintenance Allowance, Maintenance Needs Allowance, Basic Shelter Allowance and Minimum Monthly Income Allowance.
l Section 22.50 - Remedial Care Expenses
Adds the Remedial Care Expense amount effective July 1, 2014, through December 30, 2014.
l The following sections of Chapter 22 are archived:
Section 22.05.05 - 75 Percent FPG
Section 22.05.10 - 100 Percent FPG
Section 22.05.15 - 120 Percent FPG
Section 22.05.20 - 135 Percent FPG
Section 22.05.25 - 150 Percent FPG
Section 22.05.30 - 175 Percent FPG
Section 22.05.35 - 185 Percent FPG
Section 22.05.40 - 200 Percent FPG
Section 22.05.45 - 215 Percent FPG
Section 22.05.50 - 250 Percent FPG
Section 22.05.55 - 275 Percent FPG
Section 22.05.60 - 280 Percent FPG
Chapter 23 - MA Payment of Long-Term Care (LTC) Services
l Section 23.15.10.10 - Family Allocations
Updates information in the examples to reflect dates and amounts effective as of July 1, 2014.
Chapter 24 - Medical Spenddowns
l Section 24 - Medical Spenddowns
Updates the FPG standard and spenddown standard for pregnant women to be 278% FPG and 133% FPG, respectively. Also removes worker instructions to allow the work expense deduction when calculating income and the earned income disregard, dependent care deduction and child support deduction when calculating the spenddown.
In the example provided after Step 3 in the "Spenddown Steps: Determining MA Eligibility With a Spenddown" section, updates information to reflect the FPG standard of 275% FPG for children age 2-18 and the spenddown standard of 133% FPG.
Removes instruction that directed workers to use budget worksheets when calculating MA budgets and spenddowns manually.
l Section 24.10.10 - Six-Month Spenddown
Updates the spenddown standard for parents, children and pregnant women to 133% FPG.
l The following section of Chapter 24 is archived:
Section 24.10.10.05 - Six-Month Spenddown Example