MDHS Health Care Programs Manual (Eligibility Policy)
Manual Letters - below is manual letter #11.
Latest changes to manual are in red.
STATE OF MINNESOTADEPARTMENT OF HUMAN SERVICES444 LAFAYETTE ROADST. PAUL, MN 55155-3848MDHS HEALTH CARE PROGRAMS MANUALMANUAL LETTER #11September 1, 1999Effective Date: October 1, 1999 | |
TO: | MinnesotaCare Operations County Agencies |
SUBJECT: | Revised Material for the MDHS Health Care Programs Manual |
The material issued with this manual letter contains new and revised information for the Health Care Programs Manual. Changes are identified in red.
If you ask, we will give you this information in another form, such as Braille, large print, or audiotape.
New material issued with this manual letter is effective October 1, 1999, unless otherwise noted. Please review the entire manual letter for a complete description of new and changed material.
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HIGHLIGHTED CHANGE #1: This manual letter adds information on the Medical Assistance for Employed Persons with Disabilities (MA-EPD) program. This information was previously issued in Bulletin #99-16-6 (State Approves New MA Option for Employed Persons with Disabilities) dated July 21,1999, and was effective July 1, 1999. See §0907.21.07.05 (MA for Employed Persons with Disabilities), §0913.01.03 (MA-EPD Premiums) and Attachment A for a description of this change.
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HIGHLIGHTED CHANGE #2: This manual letter deletes the exception to the MinnesotaCare 18-month rule for people who apply for MinnesotaCare within 1 month of termination from MA or GAMC. Former MA/GAMC enrollees are subject to the same insurance barriers as all other MinnesotaCare applicants. See §0910.11.03 (18-Month Rule). This change is a result of legislation effective July 1, 1999. It was inadvertently omitted from Manual Letter #10.
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HIGHLIGHTED CHANGE #3: This manual letter increases the deduction for boarders to $127 per month and the combined roomer/boarder deduction to $198 per month for MA and GAMC Method A. See §0911.09.03.17 (Roomer/Boarder Income).
The boarder and combined roomer/boarder amounts in effect from October 1998-September 1999 were not included in the Health Care Programs Manual. These amounts ($125 for boarder and $196 for roomer/boarder) have been added to the on-line manual for footer months 10/98 through 9/99.
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See Attachment A for a description of other changes.
Address individual case policy questions to:
Health Care Programs Policy Center
Fax # 651-215-9438 or 1-888-234-5189.
Sincerely,
Mary B. Kennedy, Medicaid Director
Assistant Commissioner Health Care
MDHS HEALTH CARE PROGRAMS MANUAL
MANUAL LETTER #11
ATTACHMENT A
REVISED AND DELETED PAGES
All revised pages and sections are dated October 1999.
Revised Sections | Sections Deleted |
1) 0901 2) 0903.03 3) 0906.13.03.03 4) 0907.09 5) 0907.19.05 6) 0907.21.07.05 7) 0907.23.03 8) 0907.23.09.03 9) 0907.27 10) 0909.05 11) 0909.11.01 12) 0910.11.03 13) 0911.09.03.17 14) 0912.05.07 15) 0912.05.09.03 16) 0913 17) 0913.01.03 18) 0913.02 19) 0914 20) 0914.03.03 21) 0915.07 22) 0915.11 23) 0918.13 | 1) 0901 2) 0903.03 3) 0906.13.03.03 4) 0907.09 5) 0907.19.05 6) None (new) 7) 0907.23.03 8) 0907.23.09.03 9) 0907.27 10) 0909.05 11) 0909.11.01 12) 0910.11.03 13) 0911.09.03.17 14) 0912.05.07 15) 0912.05.09.03 16) 0913 17) None (new) 18) 0913.02 19) 0914 20) 0914.03.03 21) 0915.07 22) 0915.11 23) 0918.13 |
§0901 (Table of Contents) adds new sections.
§0903.03 (Client Rights) adds information about the county’s obligation to provide people with information about how to file a written application and the consequences of delaying filing. It also adds that people are exempt from garnishment of wages and other income while receiving MA, GAMC or MinnesotaCare and for 6 months after termination.
§0906.13.03.03 (Medical Support Referral--Newborns) removes references to the Paternity Information Sheet (DHS 3036) and Your Child’s Paternity (DHS 3036A). These forms are no longer used. If a pregnant woman wishes to begin working with IV-D to establish paternity or medical support before the end of the postpartum period, refer her to the IV-D agency in her county of residence.
§0907.09 (MinnesotaCare Pregnant Women) adds physician’s assistants to the list of medical providers who may verify pregnancy.
§0907.19.05 (MA Basis: Pregnant Women) adds physician’s assistants to the list of medical providers who may verify pregnancy.
§0907.21.07.05 (MA for Employed Persons With Disabilities) is a new section with information on eligibility requirements for the Medical Assistance for Employed Persons with Disabilities (MA-EPD) program.
§0907.23.03 (MA Waiver Programs: CADI) adds that people may remain eligible for CADI services after they reach age 65 if their needs cannot be met through other programs and the cost of CADI services is less than the cost to MA for a health care facility.
§0907.23.09.03 (TEFRA--SMRT Procedures) clarifies to leave MA open after the recertification date if the household is cooperating with obtaining medical information for the recertification.
§0907.27 (MA/GAMC Basis: IMD Residents) under GAMC clarifies that people who would be eligible for MA except for IMD residence are eligible for all MA services while on conditional or convalescent release or as an inpatient in a medical hospital.
§0909.05 (Asset Limits) corrects the limits for QMB, SLMB, QI and Senior Drug. The asset limit for these programs is $6,000 for households of 2 or more. Do not add $200 for additional household members when the household size exceeds 2.
This section also adds that the asset limit for MA-EPD is $20,000 regardless of household size. Count only the MA-EPD applicant or enrollee’s assets. Do not consider spousal assets.
§0909.11.01 (Additional Excluded Assets for Method A/B) adds to exclude retirement funds and medical expense accounts for MA-EPD.
§0910.11.03 (18-Month Rule) deletes the exception for people who apply for MinnesotaCare within 1 month of termination from MA or GAMC.
§0911.09.03.17 (Roomer/Boarder Income) updates the boarder and combined roomer/boarder amounts.
§0912.05.07 (Dependent Care Deduction) adds that amounts paid for dependent care by 3rd parties such as the child care subsidy funds are not allowed as a deduction. This does not apply to amounts court ordered for dependent care as part of a child support order.
§0912.05.09.03 (Earned Income Disregard Cycle--Method A) modifies the 1st example and the instructions for restarting the 30+1/3 disregard cycle to clarify the use of the 30+1/3 disregard.
§0913 (Premiums and Spenddowns) adds to MA that some MA-EPD enrollees must pay monthly premiums and adds cross references to sections with detailed information on MA-EPD premiums.
§0913.01.03 (MA-EPD Premiums) is a new section containing instructions on computing the MA-EPD premium and premium collection.
§0913.02 (Premium Payment Options) adds information on acceptable means of payment for MA-EPD and treatment of dishonored payments.
§0914 (Service Delivery) revises the list of managed care counties.
§0914.03.03 (Managed Care Exclusions) updates the list of health plans whose members are not required to enroll in managed care, but who may choose to enroll in the same health plan. It also clarifies exclusions for SIS-EW.
§0915.07 (Change in Income) adds to adjust MA-EPD premiums between scheduled reviews only if the reported change results in a decreased premium
§0915.11 (Fail to Pay Premium/Voluntary Cancellation) adds information on failure to pay the MA-EPD premium by the due date and good cause provisions.
§0918.13 (Minnesota Children with Special Health Needs) clarifies that the $15,000 annual benefit limit applies to all services, not just inpatient hospitalization. It corrects the MCSHN acronym in several places.
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