This manual letter lists new and revised material for the Health Care Programs Manual (HCPM). Unless otherwise noted, new and revised instructions are effective November 1, 2011.
This manual letter provides revised information related to the MinnesotaCare All or Nothing Rule that incorporates Bulletin #10-21-13, "MMIS Changes to Support MinnesotaCare Citizenship and Immigration Status Verification Requirements” and Bulletin #11-21-05, ”Simplifying the MinnesotaCare All or Nothing Rule.”
Manual Letter #46 also revises information regarding the waiver of a transfer penalty for Medical Assistance (MA) payment of Long-Term Care (LTC) service, archives information related to the Minnesota Disability Health Options for People with Physical Disabilities (MnDHO) health care program that ended December 31, 2010, and updates references to the Traumatic Brain Injury (TBI) Waiver Program to its new name, the Brain Injury (BI) Waiver Program.
Additional updates in this manual letter include a clarification regarding eligibility requirements for MA payment of LTC services, information regarding eligibility for MA for adults without children for Group Residential Housing (GRH) recipients, and updated information related to referrals for Social Security benefits.
Chapter 3 - Eligibility Groups and Bases of Eligibility
Updates information relating to eligibility for MA for adults without children for GRH program recipients, removes information related to MnDHO and updates references to TBI.
Chapter 4 - Social Security Administration Benefits
Adds clarification regarding when not to refer clients for Social Security Benefits and removes information related to MnDHO.
Chapter 6 - Client Responsibilities
Adds information regarding referrals for Social Security Benefits.
Chapter 10 - Social Security Number
Incorporates Bulletin #11-21-05.
Chapter 11 - Citizenship and Immigration Status
Incorporates Bulletin #10-21-13.
Provides clarification about the medical support referral process.
Chapter 17 - Household Composition
Incorporates Bulletin #10-21-13 and Bulletin #11-21-05.
Adds clarification regarding asset verification; adds new information about MA asset reduction; and provides additional guidance in the evaluation of a request to waive a transfer penalty for MA payment of LTC services.
Chapter 23 - MA Payment of Long-Term Care Services
Provides clarification regarding the eligibility requirements for MA payment of LTC services.
Chapter 24 - Medical Spenddowns
Removes information related to MnDHO.
Contains new, revised and obsoleted terms.
Contains a new form.
Chapter 3 - Eligibility Groups and Bases of Eligibility
l Section 03.30.30 - MA for 1619(a) and 1619(b).
Removes information related to the MnDHO program that ended December 31, 2010.
l Section 03.30.35 - MA for People Receiving Minnesota Supplemental Aid (MSA).
Removes information related to the MnDHO program that ended December 31, 2010.
l Section 03.40.05 - Community Alternative Care (CAC).
Removes information related to the MnDHO program that ended December 31, 2010.
l Section 03.40.10 - Community Alternatives for Disabled Individuals (CADI).
Removes information related to the MnDHO program that ended December 31, 2010.
l Section 03.40.15 - Developmental Disabilities (DD).
Removes information related to the MnDHO program that ended December 31, 2010.
l Section 03.40.20 - Brain Injury (BI).
Removes information related to the MnDHO program that ended December 31, 2010 and updates TBI to BI.
l Section 03.45.20 - Group Residential Housing (GRH).
Adds clarification that GRH recipients with a MA basis of eligibility of an adult without children do not automatically qualify for MA and that those who are denied MA can apply for MinnesotaCare. Also removes information related to the MnDHO program that ended December 31, 2010.
Chapter 4 - Social Security Administration (SSA) Benefits
l Section 04.35 - Referrals for Social Security Benefits.
Adds instruction not to refer clients between the ages 62 and the person’s full Social Security retirement age to SSA for early retirement benefits, and clarifies that applying for early retirement benefits is not a requirement for MA eligibility.
l Section 04.45.05 - Medicare Part D and Minnesota Health Care Programs (MHCP).
Removes information related to the MnDHO program that ended December 31, 2010.
Chapter 6 - Client Responsibilities
l Section 06.15 - Applying for Other Benefits.
Adds a reference and link to Section 04.35, ”Referrals for Social Security Benefits,” as it relates to the requirement for MA clients to apply for benefits from other programs for which they appear eligible.
Chapter 10 - Social Security Number (SSN)
l Section 10 - Social Security Number (SSN).
Incorporates Bulletin #11-21-05 by removing a reference to the MinnesotaCare All or Nothing Rule and eliminating the provision that MinnesotaCare coverage cannot be approved for any household member until all members have provided Social Security Numbers or proofs of application.
Chapter 11 - Citizenship and Immigration Status
l Section 11.05.15 - Cooperation with Documentation Requirements.
Incorporates Bulletin #10-21-13 by removing the application of the All or Nothing Rule in verifying citizenship and identity for MinnesotaCare cases.
l Section 16.05.05 - Referral Process.
Adds information that MA workers are not required to send medical support forms or referral documentation to the child support office if a referral was completed via the MAXIS and PRISM automated interface.
Chapter 17 - Household Composition
l Section 17.10.15 - All or Nothing Rule.
Incorporates Bulletins #10-21-13 and #11-21-05 by removing the requirement to apply the All or Nothing Rule for Social Security Numbers and the verification of citizenship and immigration status.
l Section 17.20 - Adding a Household Member.
Incorporates Bulletins #10-21-13 and #11-21-05 by removing the All or Nothing Rule from information relating to Social Security Numbers and citizenship and immigration status for new MinnesotaCare household members. Also, adds a clarification that state residence information should be requested from a new household member only if the member is applying for coverage.
l Section 19.20 - Verification of Assets.
For MA Method B, adds instruction to follow MA Method A asset verification requirements except at application or when a change is reported.
l Section 19.35.10 - MA Excess Assets.
Adds clarification on when repayment of MHCP benefits is an acceptable method of reducing assets.
l Section 19.40.40 - Waiver of Transfer Penalty.
Provides additional guidance to agencies in evaluating whether an imminent threat exists to a client’s health and well-being as well as items to consider when determining if there are no other alternatives besides MA payment of LTC services. Also, introduces the Hardship Waiver Request for Information (DHS-6364), which agencies can use to request information needed from clients who request for a waiver of the transfer penalty.
Chapter 23 - MA Payment of Long-Term Care (LTC) Services
l Section 23 - MA Payment of Long-Term Care (LTC) Services.
Adds clarification that the eligibility requirements for MA payment of LTC services apply regardless of the length of stay in a long-term care facility.
Chapter 24 - Medical Spenddowns
l Section 24.10.05 - Monthly Spenddowns (Automated).
Removes information related to the MnDHO program that ended December 31, 2010.
l BI (New).
l Brain Injury (New).
l Community Spouse (Revised).
l Long-Term Care Services (Revised).
l TBI (Removed).
l Traumatic Brain Injury (Removed).
l Hardship Waiver Request for Information (DHS-6364) (New).