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Because QI beneficiaries are not eligible for other Medicaid program benefits, the Federal payment of their Medicare Part B premiums assures access to the full array of Medicare benefits. Therefore, extension of the QI program is essential to State operations and beneficiaries.

State Action: No action is required by the States to implement this provision.

Section 112: Application of Low-Income Subsidy (LIS) Resource Tests to Medicare Savings Programs (MSPs)

Section 112 of MIPPA amends section 1905(p)(1)(C) of the Social Security Act (the Act) to make the resource limit for Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLMB) and QIs conform to the resource limit for individuals who qualify for the full subsidy under the Medicare Part D LIS program, effective January 1, 2010. This new resource limit does not apply to all MSPs. The resource limit for Qualified Disabled Working Individuals (QDWI), set forth in 1905(s) of the Act, was not changed by MIPPA.

Effective January 1, 2010, the resource limits for QMB, SLMB and QI programs are $6,600 for a single person and $9,910 for a married person living with a spouse and no other dependents. These resource limits are adjusted January 1 of each year, based upon the change in the annual consumer price index (CPI) since September of the previous year. States must use the new resource limits when determining eligibility for these programs.

Beneficiary Impact: Increasing the resource limits for the QMB, SLMB and QI programs to match the LIS resource limits allows beneficiaries to have additional resources and still be eligible for these programs.

State Action: Currently, the resource limits for the QMB, SLMB and QI programs are set forth in the State Medicaid plan and States will need to update their State plans to reflect this change in policy. Additionally, States will have to change their eligibility systems and publications to reflect this change.

Section 113: Eliminating Barriers to Enrollment

Under section 113 of MIPPA, the Social Security Administration (SSA) is directed to transmit data from the LIS application, with the consent of the beneficiary, to the Medicaid agency for determination of benefits under an MSP. The State is directed to treat the data as an application for MSP benefits, as if it had been submitted directly by the applicant.

Since 2005, CMS has transmitted data received from SSA from the LIS application as “leads data” to States. A State had the option to process or follow-up on the data transmitted. Beginning January 1, 2010, however, SSA will now transmit the LIS data directly to the State Medicaid agency, which must act upon this information as if it were an application for MSP, even if the LIS application was denied by SSA. Changing this data file from “leads data” to an “MSP application initiation file” will result in the provision of information to beneficiaries of the availability of the MSPs, and facilitate beneficiaries’ application for these programs.