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).