MEMORANDUM

DATE:          December 1, 2005

TO:               All Aged, Disabled and Long Term Care Medicaid Manual Holders

FROM:         Policy and Program Development Team

                      Ellie Fitzjarrald, Chief

SUBJECT: Aged, Disabled and Long Term Care Medicaid Manual Change #3

This manual change includes policies and processing instructions for Medicare’s low-income subsidy (LIS ) program, and makes other technical changes. It also adds the 2006 Long Term Care community spouse resource and income allowance, and household member standards, and adds two new addendums to describe the low-income subsidy levels and provide information about the Medicare approved drug plans for Alaska. In addition, instructions for advising Medicaid/Medicare recipients about changes in prescription drug coverage are provided below.

Highlights of these policy additions and other clarifications are described below.  

If you have any questions, please contact any member the Policy and Program Development Team at 465-3347 or email dpapolicy@health.state.ak.us.

NEW MEDICAID COVERAGE POLICY

Beginning January 1, 2006, Medicaid will no longer pay for prescription drugs for recipients who are eligible for Medicare. On November 18, 2005, current Medicaid/Medicare dual eligible recipients were sent an EISEligibility Information System auto-generated notice telling them about this change.  

Implementation: A manual notice, M710 - Medicare Drug Coverage Begins is now available in EISEligibility Information System. Once a Medicaid recipient becomes eligible for Medicare, he or she will loose prescription drug coverage through Medicaid. Effective with this manual change, the caseworker must send this notice to all new Medicaid recipients as soon as it becomes known that Medicare eligibility exists.

OVERVIEW OF CHANGES

ADLTC MS 505 -  Third Party liability ( TPL ) and Recovery

Instructs caseworkers to send an email message to Division of Health Care Services TPLThird Party Liability staff if it appears a minor child has health insurance coverage.

ADLTC MS 554 - Transfer of Resources

Clarifies that a MED 3, Declaration / Denial of Asset Transfer, or notice M723, Transfer of Asset Declaration, must be obtained for all nursing home and home and community based waiver applicants.

ADLTC MS 580-D - Low-Income Subsidy Program

This new section provides information about the Medicare Part D Low-Income Subsidy program.

Addendum 1 - Program Standards

Includes the Annual Federal Poverty Guidelines for Alaska for processing Medicare low-income subsidy applications, and updates the annual community spouse maintenance resource and income standards.

Addendum 6 - Low-Income Subsidy Guide

Shows eligibility criteria for the Medicare Part D Low-Income Subsidy and SeniorCare prescription drug benefit, and describes how this assistance affects the cost of Medicare Part D premiums, deductibles, and co-payments or co-insurance.

Addendum 7 - Medicare Prescription Drug Plans for Alaska

Provides information about the Medicare approved prescription drug plans for Alaska as of October 10, 2005.

MANUAL CHANGE FILING INSTRUCTIONS