STATE OF ALASKA

Department of Health and Social Services

Division of Public Assistance

TRANSMITTAL NUMBER:   MC #14

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

Date:  January 4, 2010

Beginning January 1, 2010, Medicaid policies will change as follows:

• Low Income Subsidy applications received and processed by the Social Security Administration may act as an application for Medicare Savings Programs (QMB , SLMBSpecified Low Income Medicare Beneficiaries, SLMBSpecified Low Income Medicare Beneficiaries Plus, and QDWIQualified Disabled and Working Individuals), as well as any other Medicaid categories for which the individual may qualify.  In addition, the resource limits for Medicare Savings Programs are raised to match the Low Income Subsidy levels. These amounts, which are listed in a new table in Addendum 1, will be adjusted annually. Any applications received as a result of this provision will be funneled through a single DPADivision of Public Assistance worker in Anchorage.
  
• A data match with Social Security through the State Verification Exchange System (SVES ), confirming the individual’s citizenship status via their Social Security Number, will be acceptable documentation of citizenship and identity for Medicaid purposes.  

In addition, Addendum 6 has been updated with new resource limits for the Low Income Subsidy program. Addendum 7 has also been updated to list new Medicare Part D Prescription Drug Plans for Alaskans and correct existing plan names and phone numbers.  Other revisions include technical corrections and policy clarifications suggested by field staff.

Other highlights to 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 500 C  Medical Services Received Out-of-State

• Changes First Health Services Corporation to Affiliated Computer Systems (ACS ).

MS 500 D  Freedom of Choice Providers

• Changes the name of the Medicaid Lock-In Program to Care Management Program.

MS 500 E  Freedom of Choice Restriction – Care Management Program

• Changes First Health Services Corporation to Affiliated Computer Systems (ACS ).
• Changes ACSAffiliated Computer Systems email contact to Jason Ball.
• Changes the name of the Medicaid Lock-In Program to Care Management Program.

MS 506 E  Medicare Deductible/Coinsurance

• Updates Medicare Part D information with 2010 amounts.

MS 520 B  US Citizenship and Eligible Alien Status

• Clarifies verification of U.S.United States citizenship and identity are not required for children who are eligible for newborn Medicaid.
• Removes policy that requires documentation of US citizenship when newborn Medicaid ends and clarifies that no further documentation is required.
• Adds SVESState Verification Exchange System to the data matches under Documenting U.S.United States Citizenship and clarifies that an additional form of identity verification is not required when citizenship is verified through SVESState Verification Exchange System.
• Adds SVESState Verification Exchange System to Data Matches and Interfaces and explains the data match process.
• Revises the description of tribal documents that are acceptable as level one verification of both citizenship and identity to conform to language specified in federal law.
• Adds verification of citizenship status and identity through SVESState Verification Exchange System to level one verification.

MS 534 D  Disability Determination Needed

• Corrects cross reference from Administrative Procedures MSManual Section 105-12 to MS 115-9.

MS 550 C  Special Long Term Care Eligibility Category

• Clarifies that individuals who can qualify for Medicaid under the regular need standards are not subject to the Long Term Care income eligibility standard.

MS 554 G-4  Transfers to a Spouse, Child, or a Disabled Person

• Clarifies that a transfer to a disabled individual who is not a spouse or child must be put into a special needs trust to avoid a transfer of asset penalty.

MS 580   Medicare Premium Assistance Categories

• Explains the LISLow Income Subsidy referral process for Medicare Savings Programs.

MS 580 A   Qualified Medicare Beneficiaries (QMB )

• Clarifies that resource limits for QMBQualified Medicare Beneficiaries cannot exceed the amounts listed in Addendum 1 under QMBQualified Medicare Beneficiaries, SLMBSpecified Low Income Medicare Beneficiaries, SLMB+ , and QDWIQualified Disabled and Working Individuals Resource Limits.

MS 580 C   Qualified Disabled and Working Individuals

• Clarifies that resources for QDWIQualified Disabled and Working Individuals cannot exceed the amounts listed in Addendum 1 under QMBQualified Medicare Beneficiaries, SLMBSpecified Low Income Medicare Beneficiaries, SLMB+ , and QDWIQualified Disabled and Working Individuals Resource Limits.

MS 580 D   Low Income Subsidy (LIS ) Program

• Clarifies the eligibility criteria  for reduced subsidies and removes repetitive language under income levels.
• Updates subsidy level deductible and co-pay amounts.
• Changes the number of organizations that have Medicare Part D plans in Alaska from thirteen to seventeen.

Addendum 1   Program Standards

• Adds a table to provide resource limits for Medicare Savings Programs (QMB , SLMBSpecified Low Income Medicare Beneficiaries, SLMB+ , and QDWIQualified Disabled and Working Individuals).

Addendum 6   Medicare Part D Low Income Subsidy Guide

• Updates addendum with 2010 amounts.

Addendum 7   Medicare Prescription Drug Plans for Alaska

• Updates company names, plan names, and phone numbers.