STATE OF ALASKA

Department of Health and Social Services

Division of Public Assistance

TRANSMITTAL NUMBER:  MC Manual Change #47

MANUAL:  Family Medicaid

DATE:  October 1, 2010

We are making several changes to incorporate new policy, clarify existing policy, and align policies within our program policy manuals. This includes:

• A written request from the recipient is a valid reason to end a child's continuous eligibility period.

• A client can request retroactive Medicaid at any time, even if they have been previously denied for failing to provide requested verification.

• To the extent possible, we are aligning policies in the U.S. United States Citizenship and Alien Status chapter with those in our other program manuals.  Also, individuals that receive SSDI Social Security Disability Insurance, SSI Supplemental Security Income, or Medicare are only exempt from verifying their citizenship status if they claim to be a U.S. United States citizen or national.  Non-citizens must still verify their alien status.

• Any amount of Flexible Health Benefits that the employer does not pay directly to the employee is exempt income.

• New policy allows a 50% deduction from self employment income for self-employment expenses.  The household can choose to use actual expenses if they believe they are higher than 50%.

Other changes are either technical in nature or clarifications that are the result of policy questions or 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 5005-2B  When is an Application Required?

• Clarifies that a Denali KidCare recipient who does not have any other active public assistance cases must submit an application for another Medicaid category, such as Family Medicaid.

MS 5005-4E  Scheduling Interviews

• Removes the requirement to send a written notice to the applicant informing them of their interview date and time.
• Includes three options for informing the applicant of their appointment date and time as well as documentation requirements for each option.

MS 5005-6  Actions Taken on the Application

• Clarifies that the first month of the review period is the first month the household is found eligible for Medicaid.

MS 5005-6B  Benefits Start Date

• Clarifies that the benefit start date for Medicaid is the first of the month that the household is found eligible.

MS 5005-7A  Review Requirements

• Clarifies that when a new or review application (GEN 50B or GEN 72 Eligibility Review Form) is received from a household, the application must be used to establish a new review / recertification period for all open programs if the household is eligible.

MS 5007  Continuous Eligibility for Children

• Adds "written request from the recipient requesting case closure" as a reason to end the continuous eligibility period.
• Clarifies that the continuous eligibility period applies to all individuals under age 19, even if the individual is the Primary Information (PI) person on their own Medicaid case.

MS 5008  Retroactive Medicaid Eligibility

• Clarifies that client statement is allowed regarding the value of a resource, unless questionable.
• Clarifies that a client can request retroactive Medicaid at any time, even if they have been denied previously for failing to provide requested verification. The caseworker can determine eligibility for retroactive Medicaid for the three months prior to any application for Medicaid.
• Clarifies that an individual requesting retroactive Medicaid must meet all of the requirements for the Medicaid category, both financial and non-financial.

MS 5011  U.S. United States Citizenship and Alien Status

• Aligns policies in the U.S. United States Citizenship and Alien Status chapter with those in our other program manuals.
• Clarifies that individuals who have received a 90-day period to provide proof of U.S. United States citizenship are not entitled to receive it again.
• Clarifies that although recipients of SSDI Social Security Disability Insurance, SSI Supplemental Security Income, or Medicare are exempt from verifying their U.S. United States citizenship, this exemption only applies to individuals that claim to be U.S. United States citizens or nationals. Non-citizens must still verify their alien status.

MS 5016B  Who Is Not Required To Cooperate

• Clarifies that the caretaker must be informed about medical support requirements after the post-partum period ends.

MS 5016-4C  Failure to Complete a Child Support Information Form (CSSD Child Support Services Division 1603a)

• Clarifies that EIS Eligibility Information System Notice M301, Medicaid Pended - Information Needed, may be used to request a completed Child Support Information (CSSD Child Support Services Division 1603a) form.

MS 5016-6A  Application Materials to CSSD Child Support Services Division

• Clarifies that if a birth certificate for a child born out of state is received after application materials have been sent to CSSD Child Support Services Division, the eligibility worker must forward a copy of the birth certificate to CSSD Child Support Services Division at that time.

MS 5018D  Exemptions for Applying for UIB Unemployment Insurance Benefit

• Clarifies that the "Caretaker of Baby" exemption is not available to two-parent families in which both adults are physically and mentally able to perform gainful activity.

MS 5120-5B  Allowable Absences Lasting More Than One Month

• Clarifies that a drug and alcohol treatment center is considered "hospitalization" in a public or private institution.

MS 5164-2  Income From Self-Employment

MS 5164-5B  Budgeting Seasonal Self-Employment Income

MS 5164-8A  Household Members As Employees

• Adds new policy that allows a 50% deduction from self employment income for self employment expenses.  The household can choose to use actual expenses if they believe they are higher than 50%.

• Removes mileage rate table and adds a link to the IRS Internal Revenue Service website for current mileage rates.

MS Manual Section 5172-2D  Flexible Health Benefits

• Clarifies that only the contribution amount that goes directly to the employee (benefit contribution excess) is countable income. Any amount that the employer pays for mandatory health insurance benefits is not counted as income to the employee.

MS 5220-2E  Counting Retroactive Family Medicaid

• Clarifies that coupons must be issued for each month(s) used, even if there are no unpaid medical bills for that month.

MS 5310A  General Eligibility Criteria

• Clarifies that parental income is not deemed if a pregnant woman is between the age of 18 and 21, and qualifies for Family Medicaid coverage during her last 90 days of pregnancy under manual section 5104-9.