Home > Manual Letters > 2009 > Manual Letter 26 (September 2009)
This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective September 1, 2009.
Bulletin #08-21-12, "Worker’s Compensation Settlements Excluded as Assets for MinnesotaCare," is incorporated into the following sections with this Manual Letter:
Section 09.05 - Mandatory Verifications.
Section 19.10 - Excluded Assets.
Section 19.20 - Verification of Assets..
Chapter 15 - Third Party Liability (TPL).
Several sections are modified based on a regularly scheduled review.
Many sections are modified based on a regularly scheduled review.
Chapter 09 - Verification Requirements.
Chapter 23 - MA Payment of Long-Term Care (LTC) Services.
Chapter 15 - Third Party Liability (TPL)
l Section 15.05 - MinnesotaCare Other Health Care Coverage Barriers.
n Clarifies existing policies.
n Name of section changed from MinnesotaCare Insurance Barriers.
n Adds a reminder that an insurance company may require a release to provide information.
n Notes that parents should not cancel coverage that is court-ordered.
n Explains that certain employer-sponsored plans must offer a special enrollment period when MA is terminated.
n Adds a new subsection regarding children with other health care coverage.
l Section 15.05.05 - Other Health Care Coverage for MinnesotaCare.
n Name of the section is changed from ”Types of Other Insurance Coverage for MinnesotaCare.”
n Clarifies that Medicare may be considered other health care coverage for purposes of the MinnesotaCare current other health care coverage barrier and the four-month rule.
n Deletes TRICARE information from this section and links to 15.30 for full information.
l Section 15.05.10 - Reporting Other Health Care Coverage for MinnesotaCare.
n Name of the section is changed from ”Documenting Insurance Coverage.”
n Renames several subsections to more accurately reflect policy.
n Clarifies health care coverage information that clients are required to report and ways they may report it.
l Section 15.05.15 - MinnesotaCare Underinsured Children.
n Name of the section is changed from ”Underinsured.”
n Clarifies types of coverage considered underinsured.
n Adds a subsection about how to verify that a child’s other health care coverage meets the requirements for being underinsured.
l Section 15.05.20 - Employer-Subsidized Insurance (ESI).
n Adds a new subsection regarding a special enrollment period when MA is terminated
n Clarifies that ESI includes union coverage.
n Minor clarifications and updates.
l Section 15.10 - Other Health Care Coverage for MA and GAMC.
n Adds long-term care insurance to the list of other types of health care coverage an MA or GAMC enrollee may have.
l Section 15.25 - COBRA.
n Clarifies existing policies.
n Explains eligibility qualifications for Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage.
n Clarifies the length of time coverage is available under COBRA and cost of coverage.
l Section 16 - Medical Support.
n Clarifies that people assign rights by accepting services.
n Explains that court orders generally require medical support payments until the child is 18.
n Notes that sometimes someone other than the noncustodial parent (known as the obligor) is court-ordered to provide medical support.
l Section 16.05 - When to Refer for Medical Support.
n Adds reference to an obligor who may be required to provide medical support.
n Minor clarifications and updates.
l Section 16.05.05 - Referral Process.
n Clarifies role of Good Cause Committee if good cause is requested in a medical support referral.
n Minor clarifications and updates.
l Section 16.05.10 - Establishing Paternity.
n Minor clarifications and updates.
l Section 16.05.15 - Minor Child Lives Apart From Both Parents.
n Adds an exception to determining if the child’s parents are considered to be custodial if the child is in IV-E foster placement.
n Minor clarifications and updates.
l Section 16.10.05 - Pregnant Women and Newborns.
n Clarifies that medical support referrals are not made during the entire postpartum period rather than 60 days after the birth.
n Minor clarifications and updates.
l Section 16.15.05 - Initial Good Cause Determinations.
n Clarifies that the Notice of Privacy Practices (DHS-3979) should be sent to the client along with the Important Information About Your Request for a Child Support Good Cause Exemption (DHS-3627) when a good cause claim is received by the good cause committee.
n Minor clarifications and updates.
l Section 16.15.10 - Evidence of Good Cause.
n Clarifies that records supporting a good cause claim can include those by advocacy services.
n Clarifies that evidence supporting a good cause claim may show how the alleged father might cause emotional harm.
n Section 07.30 - Case Notes.
Adds two items that must be included in case notes: a description of how the asset total is calculated and changes in assets reported.
n Section 08.35 - Six-Month Renewals.
m Adds a subsection explaining processing requirements for late six-month renewals.
Chapter 09 - Verification Requirements
n Section 09.05 - Mandatory Verifications.
m Incorporates bulletin #08-21-12, ”Worker’s Compensation Settlements Excluded as Assets for MinnesotaCare.”
m Explains that Worker’s Compensation settlements must be verified if the reported amount causes assets to exceed the asset limit for MinnesotaCare.
n Section 19.05 - Asset Limits.
m Clarifies that MA-EPD uses the standard household size if the MA-EPD client is also on a disability waiver program, instead of a household size of one.
n Section 19.10 - Excluded Assets.
m Incorporates bulletin #08-21-12, "Worker’s Compensation Settlements Excluded as Assets for MinnesotaCare."
m Explains to exclude all Worker’s Compensation settlements as an asset for MinnesotaCare and to exclude up to $10,000 of court-ordered settlements for MA Method A and GHO.
n Section 19.20 - Verification of Assets.
m Incorporates bulletin #08-21-12, "Worker’s Compensation Settlements Excluded as Assets for MinnesotaCare."
m Adds Workers Compensation as a required asset verification for MinnesotaCare if the settlement causes the client to exceed the asset limit.
n Section 19.35.10 - MA and GAMC Excess Assets.
m Clarifies asset policy for MA when MA-EPD is ending. Apply the MA-EPD asset rules and the $20,000 asset limit when determining basic MA eligibility for up to 12 months after the person loses MA-EPD status.
n Section 20.25.15 - Lump Sum Income.
m Adds Worker’s Compensation settlements as an example of lump sum income.
m Clarifies information on non-recurring income for self-employed people.
m Adds an exception for MA Method A lump sum income: Do not count the first $10,000 of court-ordered Worker’s Compensation settlements.
n Section 20.25.20.05 - MinnesotaCare Self-Employment Income.
m Updates the tax forms chart for MinnesotaCare self-employment to include Schedule E (Form 1040).
n Section 20.30 - Income Changes.
m Deletes Transitional MinnesotaCare and LTC from the list of program types under MA/GAMC explaining what to do when a client reports a change in income.
m Adds links to the Transitional MinnesotaCare section in Chapter 3 and the LTC Spenddowns and Waiver Obligations section in Chapter 23.
Chapter 23 - MA Payment of LTC Services
n Section 23.15.10 - Deductions from LTC Countable Gross Income.
m Rewords section regarding fees paid to a guardian, conservator or representative payee to clarify what amount can be used.
n Section 23.20 - LTC Spenddowns and Waiver Obligations.
m Adds clarification that changes in income and deductions must be verified at the time they are reported.
n Section A-F.
m Budget Period (modified).
m Certification Period (modified).
n Section M-R.
m Renewal Month (modified).