MC #24 (03/12)

STATE OF ALASKA

Department of Health and Social Services

Division of Public Assistance

TRANSMITTAL NUMBER: MC #24

MANUAL: Aged, Disabled and Long Term Care Medicaid Eligibility Manual

DATE: March 1, 2012

We are making several changes to clarify existing policy as a result of suggestions from the field.

Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .

OVERVIEW OF CHANGES

MS 516 Retroactive Medicaid

Adds language to indicate that the eligibility criteria for the same category of Medicaid the family is currently receiving or was receiving at the time requested is used in determining eligibility for Retroactive Medicaid.

MS 520-A Application and Review Process

Adds two exceptions to the APA Adult Public Assistance application requirements to clarify that a new application is not required when: (1) an individual is already part of an active public assistance case and the existing case file already includes the information needed to make a prospective Medicaid determination. (2) the individual is already a Medicaid recipient in another eligibility category.

Adds an exception to the APA Adult Public Assistance interview requirements for applicants to clarify that if a client has an active public assistance case, an interview is not required unless the caseworker feels it is necessary to correctly determine eligibility.

MS 528 Processing Cases with Trusts

Revi ses language to throughout this section indicate that a copy of the trust document must be emailed to dpapolicy@alaska.gov for review and approval. The current policy requires trust documents to be faxed to the Medicaid Eligibility Program Officer or designee.

Revises language to indicate throughout this section t hat trust information that is required to be sent to the DHCS Division of Health Care Services TPL Third Party Liability unit must be emailed to dmatpl@alaska.gov . The current policy requires trust documents to be faxed to the DHCS Division of Health Care Services TPL Third Party Liability unit.

Removes three notes in subsections B, C, and D that states to contact the LTC Long Term Care Coordinator to get the MED 21, 22, and 23 brochures. These are now available on eForms so these notes are obsolete.

Removes B(4) and C(5) because this language is now found in A(6) which provides general case processing procedures.

MS 528-D Processing Renewals with Trusts

Adds language to step 6 that requires the M140 notice to be sent in addition to the M144 notice when processing renewals for cases with a QIT Qualifying Income Trust . The M144 notice states that a separate notice will be sent explaining the amount of money that the client may access for living allowance and there is not another notice that currently meets this requirement.

MS 528-G Trust Changes

Adds a note to indicate that caseworkers must request and obtain a copy of the court document showing that the court approved revisions to an irrevocable trust.

MS 533 Disabled Children at Home ( TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 )

Removes AKA acronym from the section title because it is not needed.

Revises language in the first paragraph to indicate that caseworkers in the LTC Long Term Care unit process TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 cases. Previous policy stated that designated caseworkers in each DPA Division of Public Assistance region process TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 cases.

Removes language throughout this section that states that the LTC Long Term Care Coordinator is in Field Services because this position is now in Policy and Program Development, but the information is not necessary.

Replaces “Long Term Care” with the LTC Long Term Care glossary term where appropriate throughout this section.

MS 533-A TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 Eligibility

Adds exceptions to the APA Adult Public Assistance income and resource policies for Coverdell funds, 529 plans (also known as a Qualified Tuition Program), and UTMA/UGMA accounts used when determining TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 eligibility.

Adds an exception that indicates that only the TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 child’s income and resources are countable for TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 eligibility.

MS 533-C Referral and Interagency Communications

Adds language in subsection 3 that indicates that if the DDS Disability Determination Service decision is a denial of disability, the DPA Division of Public Assistance LTC Long Term Care Coordinator will issue a closure letter to the parent(s).

Adds language in subsection 4 that indicates that the DPA Division of Public Assistance caseworker is responsible for sending the MED 15 and entering a CANO Case Notes stating that both the MED 15 and MED 16 were sent to the parents or guardian whenever an application is received for TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 Medicaid.

MS 533-E TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 Reviews

Revises language to indicate that TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 cases now have a twelve-month continuous eligibility period. Previous policy indicated that TEFRA Tax Equity and Fiscal Responsibility Act, P.L. 97-248 cases had a six-month continuous eligibility period.

MS 534-C Income

Adds a note to clarify that an income allocation for an ineligible child is not allowed in the Family Income Test because income allocations are part of the APA Adult Public Assistance spousal deeming process. Includes a link to APA Manual Section 460-5A .

MS 534-K Example of an Eligibility Determination

Updates the Income Standards to the 2012 amounts throughout this subsection.

MS 534-M Example of an Eligibility Determinat ion with a Medicaid Qualifying Trust

Updates the Income Standards to the 2012 amounts throughout this subsection.

MS 553 Preventing Spousal Impoverishment

Updates the Maximum Community Spousal Resource Allowance to the 2012 standard of $113,640 in the examples in subsection D. Previous manual uses 2004 standard of $92,760 which is outdated.

Removes the terms “Long Term Care” and “Home and Community-Based” because they are duplicated by glossary terms and clutter up subsections D, E, F, and G.

MS 554 Transfer of Assets

Removes the language about how to treat a transfer of asset for less than fair market value before implementation of the Deficit Reduction Act of 2005 provisions in subsections D, E, and L. By February 2011, any transfer of assets for less than fair market value will require a 60-month look-back period.

R enumbers remaining examples as 1- 10 throughout this section due to deleted policies.

MS 554-J Life Estates

Updates the link to the current life estate tables published by SSA Social Security Administration at https://s044a90.ssa.gov/apps10/poms.nsf/lnx/0501140120 .

MS 560-B HCB Home and Community-Based Waiver Types

Revises language to indicate that there are five types of HCB Home and Community-Based waivers. Previous policy stated that there were four types of HCB Home and Community-Based waivers.

Adds FASD Fetal Alcohol Spectrum Disorder waivers as a type of HCB Home and Community-Based waiver.

MS 560-C Eligibility for HCB Home and Community-Based Waiver Services

Adds FASD Fetal Alcohol Spectrum Disorder waivers as a type of HCB Home and Community-Based waiver.

MS 560-F HCB Home and Community-Based Waiver Services and Institutional Eligibility

Adds a note that indicates that the Preventing Spousal Impoverishment ( Section 553 ) and Post-Eligibility ( Section 570 ) policies do not apply to FASD Fetal Alcohol Spectrum Disorder waivers.

MS 561-F APD, MRDD, or OA Waivers with APA Cash Assistance

Corrects AO waiver to OA waiver in title.

MS 561-I FASD Fetal Alcohol Spectrum Disorder Waiver

Adds new policy for FASD Fetal Alcohol Spectrum Disorder waiver EIS Eligibility Information System codes.

MS 562 Processing HCB Home and Community-Based Waiver Cases

Revises the policy to state that all HCB Home and Community-Based waiver cases have a twelve-month review period in subsections B, J, and L. This policy changed a while ago, but a few references to a six-month review period were not changed.

MS 562-B Processing HCB Home and Community-Based Waiver Cases When a DDS Determination is Pending

Removes language that states that the LTC Long Term Care Coordinator is in Field Services because this position is now in Policy and Program Development, but the information is not necessary.

MS 562-F Processing HCB Home and Community-Based Waiver Cases for Title IV-E Eligible Individuals

Adds the word “Title” before “IV-E” in step 3 for clarity.

MS 562-K Processing FASD Fetal Alcohol Spectrum Disorder Waiver Cases

Adds new section K that provides processing procedures for FASD Fetal Alcohol Spectrum Disorder waiver cases. Includes information on the benefit start date, a list of notices, and HCB Home and Community-Based waiver policies that do not apply to the FASD Fetal Alcohol Spectrum Disorder waiver type.

Renumbers remaining sections as 562-L to 562-N.

MS 570-F When a Cost-of-Care Liability Begins and Ends

Clarifies that if only a screening coupon is issued for a benefit month, the caseworker must notify the EIS Eligibility Information System Help Desk to add a cost-of-care liability amount on the EIS Eligibility Information System COCA Cost of Care screen for that month.

MS 570-H Nursing Home Examples

Updates the Community Spouse Monthly Maintenance Need Standard to the 2012 amount of $2,841.00 in example 2.

MS 570-J Home and Community-Based Waiver Case Examples

Updates the Community Spouse Monthly Maintenance Need Standard to the 2012 amount of $2,841.00 in example 1.

Updates the Special LTC Long Term Care Income Standard to the 2012 amount of $2,094 in example 2.

Addendum 1 Program Standards

Corrects the 2012 Special Long Term Care Income Standard from $2,095 to $2,094.

Corrects the 2012 Monthly Need Standard for Additional Household Members from $913 to $947.

Updates Federal Poverty Guideline Table for 2012.

Updates Pickle Amendment Table to show new reduction factor amounts through December 2011.

Addendum 5 Medicaid EIS Eligibility Information System Notices

Adds missing notices to the table:

M321 - Pend Waiver Start - Child on DKC Denali KidCare

M724 - Waiver Services Denied – Medicaid Cont.

Corrects number of RPTC Residential Psychiatric Treatment Center Waiver: Info Needed – FM Family Medicaid / DKC Denali KidCare Child notice from M321 to M323 and reorders the table.

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