MEMORANDUM

DATE:            October 2, 2006

TO:                 All Family Medicaid Manual Holders

FROM:           Policy and Program Development Team

                        Carolyn Spalding, Acting Chief

SUBJECT:    Family Medicaid Manual Change #33

This manual change incorporates Medicaid and Denali KidCare policy that requires United States citizens to provide verification of their U.S. United States citizenship and identity.  This requirement is due to a change in federal law under the Deficit Reduction Act of 2005.  The policy changes were previously implemented by broadcast announcements.  Implementation in Alaska began on August 1, 2006 for Medicaid and Denali KidCare applications and renewals received on or after that date.  

Note:  

The new law does not change the eligibility or verification rules that apply to non-citizens.  Qualified aliens are still required to provide verification of their status when they apply for Medicaid benefits.

Following is the guidance provided to implement the new requirement for applications and renewals received on or after August 1, 2006:

Application Processing:

Applicants for Medicaid and Denali KidCare who declare they are U.S. United States citizens are asked to provide proof of their citizenship and identity.  If the proof is not provided with the application, and the individual is a previous recipient, the caseworker will check the case file to see if the required documents have already been provided.  If the verification is not in the file, the application will be pended and notice D/M307 will be sent requesting the verification.  Applicants may be allowed additional time beyond the normal processing timeframes if needed due to reasons beyond their control.  Applicants cannot be found eligible for Medicaid until the necessary verification is provided.  

If the household does not provide the necessary proof or does not respond by the date requested, the application must be denied using the D/M205 notice and entering the “CI” denial reason code in EIS Eligibility Information System .  

Note:  

Coverage for Medicaid/Denali KidCare is denied only for the individuals who do not provide the requested citizenship and identity verifications as required.

Renewal Processing:

As reviews are submitted, caseworkers will check the existing case file for proof of citizenship and identity for Medicaid and Denali KidCare recipients.  If the required documents are not in the file, send the D/M308 notice requesting the needed verification.  If necessary, recipients will remain eligible for Medicaid into the next month to allow time for them to respond to the request.  Recipients who provide the requested verification, or state they are trying to get the verification but are unable to provide it at this time, may be found eligible for a new review period.   In this situation, documentation will be required at the next redetermination.  A new eligibility period must be determined before a child is allowed the 6-month period of continuous eligibility.  

If the household does not provide the necessary proof or does not respond by the date requested, the case will be closed with timely adverse action using the D/M405 notice, and entering the “CI” closure reason code in EIS Eligibility Information System .  

Note:  

Coverage for Medicaid/Denali KidCare ends only for the individuals who do not provide the requested citizenship and identity verifications as required.

In an effort to comply with the federal law, and make the process as easy as possible for applicants, recipients, and staff, we have:

• Created flyers about the new Medicaid citizenship and identity verification requirements, and sent a supply of these to offices and other interested parties to hand out with applications.

• Created flyers for Denali KidCare, which are inserted into the renewal forms sent to recipients.

• Created new EIS Eligibility Information System codes for tracking the level of citizenship and identity verification provided as required by federal regulations.  

• Successfully matched over 60,000 Alaska residents with Bureau of Vital Statistics ( BVS Bureau of Vital Statistics ) data to verify citizenship.  We are continuing to pursue future automated BVS Bureau of Vital Statistics matches.

• Developed new Medicaid and Denali KidCare EIS Eligibility Information System notices for requesting citizenship and identity verification, and for denying or ending eligibility for an individual who does not provide verification.  

This manual change also includes revised self-employment policy relating to household members as employees that aligns policy for the Food Stamp, Alaska Temporary Assistance, and Family Medicaid programs.  A new section on corporations is added to explain the treatment of income and expenses from these self-employment businesses and the section on partnerships is expanded.

Also included are updates to Addenda 1 and 2 to reflect the 2006 federal poverty guidelines for Alaska, and other policy clarifications and updates, which are described below.

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

OVERVIEW OF CHANGES

5000-4(A) – Verification Requirements

Adds new Medicaid policy requiring verification of citizenship and identity for individuals who are U.S. United States citizens.

5010 – Non-Financial Factors of Eligibility

Removes references to APA Adult Public Assistance -related Medicaid categories, and adds citizenship and identity.

5011 – U.S. United States Citizenship and Eligible Alien Status

Adds policy and a list of acceptable documents that may be used to verify U.S. United States citizenship and identity.

5012- Alaska Residency  

Clarifies the definition of Alaska residency and policy for out-of-state absences.  Provides guidance on evaluating questionable residency.

5013 – Age

Removes references to APA Adult Public Assistance -related Medicaid categories.

5014 – Social Security Enumeration

Makes minor revisions to the section.

5015 – Assignment of Rights

Adds definitions, and clarifies cooperation and assignment requirements.

5035 – Residents of Institutions

Adds exception to policy for an individual age 21 who has continuously resided in an inpatient psychiatric hospital.  Also removed “Emergency Placement” section, as it is now included under “Exceptions”.

5164 – Self-Employment

• Clarifies verification requirements for self-employment income and expenses.

• Clarifies policy relating to partnerships and corporations

• Aligns policy relating to family members as employees.  The policy is now the same for Alaska Temporary Assistance, Family Medicaid, and Food Stamps.

5500 – Breast and Cervical Cancer Medicaid

Updates contact information for the Breast and Cervical Cancer Coordinator.

Addendum 1 – Denali KidCare Income Standards

Updates the Federal Poverty Guidelines for Alaska effective April 1, 2006.

Addendum 2 – Family Medicaid Income Standards

Updates the Self-Employment Income Annualization Standards, and the Transitional Medicaid Income Standards for Alaska effective April 1, 2006.

MANUAL CHANGE FILING INSTRUCTIONS

Remove Old Pages                                                                  Insert New Pages

Table of Contents                                                                       Table of Contents

GP-3 – GP-4                                                                               GP-3 – GP-4

GP-10a – GP-10y                                                                      GP-10a – GP-10z

GP-15a – GP-15d                                                                      GP-15a – GP-15d

FM Family Medicaid-47g – FM Family Medicaid-47p                                                                      FM Family Medicaid-47g – FM Family Medicaid-47r

FM Family Medicaid-55c – FM Family Medicaid-55d                                                                      FM Family Medicaid-55c – FM Family Medicaid-55d

Addendum 1 (pages 1 through 2)                                            Addendum 1 (pages 1 through 2)

Addendum 2 (pages 1 through 2)                                            Addendum 2 (pages 1 through 2)