STATE OF ALASKA

Department of Health and Social Services

Division of Public Assistance

TRANSMITTAL NUMBER:   63

MANUAL:   Alaska Family Medicaid (MAGI) Program

DATE:   March 2, 2015

The Denali Kid Care and Self-Employment Annualization income standards are based upon the Federal Poverty Guidelines ( FPG ) for Alaska as set each year by the U.S. Department of Health and Human Services. We have updated the charts in Addendum 1 and 2 to reflect these changes which take effect March 1, 2015.

Other changes are either technical in nature or clarifications that are the results of policy questions or suggestions from the field.

Highlights of these policy revisions are described below. If you have any questions please e-mail  the Policy and Program Development team at dpapolicy@alaska.gov.

OVERVIEW OF CHANGES

5005  Application Process

• Added new policy clarifying that Pregnant Women applications must be processed by the fifth working day following the application date.

5005-2 A  What is an Acceptable Application Form?

• Deleted Gen 35, Application for Medicaid for a child in DHSS Custody, from the list of specialized application forms used for non-MAGI Medicaid. Eligibility for this group is based on MAGI rules so the GEN 50C should be used.

5005-6 A Approving the Application

• Added new policy clarifying that Pregnant Women applications must be processed by the fifth working day following the application date.

5065-A  Definitions

• Clarified that if there is a cost to enroll in an employment related health insurance plan and the applicant or recipient states they cannot afford the coverage, we cannot require them to pursue it.

5185-2 Acting on Reporting Changes

• Added new policy clarifying that a report of change made for an on-going Medicaid case must be acted on by the fifth working day following the report of change.

5330  Newborn Child Eligibility

• Clarified that newborns born to women during the HPE period are not eligible for Newborn “BA” Medicaid.

5701  Parents and other Caretaker Relatives

• Clarified that a primary caretaker/parent must have child 51% of the time to meet eligibility criteria.

5730-A  Applications Submitted through the FFM

• Clarified that if an application is submitted through the FFM, DPA must notify the FFM of the eligibility decision.

5735  Hospital Presumptive Eligibility Determinations

• Added link to DPA Web for the list of qualified hospitals approved to make hospital presumptive eligibility determinations.

• Added instructions for staff to contact Policy if they receive hospital presumptive approval paperwork from a hospital not on the list or if the approval paperwork is signed by a hospital worker not listed.

Addendum 1 Denali KidCare Income Standards

• Updated with 2015 FPL Guidelines.

Addendum 2  Family Medicaid Income Standards

• Updated Self-Employment Income Annualization Standards with 2015 FPL Guidelines.

Addendum 5  MAGI Income Standards

• Updated 2015 FPL Guidelines.