*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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, 2015.
Manual Letter #73 provides annual changes effective July 1, 2015, for the following standards:
Statewide Average Payment for Skilled Nursing Facility (SAPSNF)
Home Maintenance Allowance
Maintenance Needs Allowance (SIS-EW)
Basic Shelter Allowance
Minimum Monthly Income Allowance
Remedial Care Expense
Refer to Insurance Affordability Programs (IAPs) Income and Asset Guidelines (DHS-3461A) for annual changes to income guidelines effective July 1, 2015.
Manual Letter #73 also updates information related to referrals to the State Medical Review Team (SMRT) to accurately reflect the current referral process. Workers are only required to submit a State Medical Review Team Referral for Disability Determination (DHS-6123) to SMRT to complete the referral process.
As part of the update relating to SMRT referrals, Section 12.10.05 - SMRT Disability Determinations Three-Month Waiting Period was archived as it is no longer applicable when submitting a SMRT referral.
Chapter 12 - Certification of Disability
Section 12.10 - State Medical Review Team (SMRT) Disability Determinations
Removes requirements that are no longer applicable when submitting a SMRT referral or completing a SMRT disability determination.
Section 12.15 - TEFRA Referrals to SMRT
Removes documentation requirements that no longer apply to TEFRA referrals to SMRT.
Section 12.15.05 - TEFRA Level of Care Determination
Removes references to documentation and forms that are not required to submit a TEFRA referral to SMRT.
The revisions to this chapter also include the archival of the following section:
Section 12.10.05 - SMRT Disability Determinations Three-Month Waiting Period
Chapter 22 - Standards and Guidelines
Section 22.35 - SAPSNF
Adds the SAPSNF amount effective July 1, 2015, through June 30, 2016.
Section 22.45 - Long-Term Care (LTC) Allowances
Adds the amount effective July 1, 2015, through June 30, 2016, for the Home Maintenance Allowance, Maintenance Needs Allowance, Basic Shelter Allowance and Minimum Monthly Income Allowance.
Section 22.50 - Remedial Care Expenses
Adds the Remedial Care Expense amount effective July 1, 2015, through December 30, 2015.