Subject: Various Revisions to Volume IVA

OMTL-517 Page 1 of 3

This OMTL outlines revisions in Volume IVA to update and clarify Medicaid (MA) policy and proceduresoutlined in the following manual sections.

Volume IVA

The Table of Contents has been revised to update the titles of certain manual sections and remove all obsolete manual sections.

MS 1010, Adult MA Definitions, has been revised to:

Change the title to Non-MAGI MA Definitions;
Add the definition of Modified Adjusted Gross Income (MAGI);
Clarify definitions as needed; and
Remove unnecessary definitions.

MS 1065, Co-Pay For Medicaid Recipients, is revised to update the co-payments on prescription drugs, co-payments for services, and specify that a co-payment is not imposed on hearing aids. It is further revised for clarity.

MS 1235, Disclosure of Medicaid Information, is revised for clarity.

MS 1371, Authorized Representative, is revised to incorporate policy that an Authorized Representative (AR) can receive notices and MA cards and to remove references to KAMES and replace with Worker Portal. It is further revised for clarity.

MS 1425, Case Number Assignment, is obsolete as this policy is in reference to KAMES.

MS 1510, Timely Notice of Decrease/Discontinuance, is revised to remove references to KAMES and replace with Worker Portal. It is further revised for clarity.

MS 1560, Enumeration, is revised to incorporate policy about the Federal HUB verifying an individual’s social security number (SSN) with the Social Security Administration (SSA) when applying for Non-MAGI MA. It is also revised to incorporate policy from MS 1564 and MS 1566 as those manual sections are obsolete and for clarity.

MS 1564, Failure to Comply with Enumeration, is obsolete as this policy has been added to MS 1560.

MS 1566, Enumeration Good Cause Criteria, is obsolete as this policy has been added to MS 1560.

MS 1578, Time-Limited MA Eligibility, is revised to:

Change the title to Emergency Time-Limited Medicaid;
Remove references to KAMES and replace with Worker Portal;
Add that the delivery of a baby is considered an emergency medical condition; Explain the difference between a chronic and emergency medical condition;
Clarify that it will not cover long term care (LTC);
Explain that emergency time-limited may not be issued as Spend Down or KCHIP III; and
For readability and clarity.

MS 1579, Extension of Time-Limited MA, is revised to change the title to Extension of Emergency Time-Limited Medicaid. It is further revised to update the procedure for requesting an extension of Emergency Time-Limited MA and for formatting and clarity.

MS 1700, Aged, is revised to:

Change the title to Aged/Blind/Disabled;
Incorporate blind and disabled policy from MS 1710 and MS 1720;
Clarify policy regarding field determinations of disability and MRT referrals;
Remove policy regarding MRT special examination; and
Incorporate MRT procedures completed on Worker Portal.

MS 1710, Blind, is obsolete as this policy has been added to MS 1700.

MS 1720, Disabled, is obsolete as this policy has been added to MS 1700.

MS 1810, Blind or Disabled Child Living with Parents, is revised for clarity and readability.

MS 1880, Excluded Resources, is revised to:

Remove reference to form MA-10, Reasonable Effort to Sell Checklist, as the form is no longer required as the questions have been incorporated into Worker Portal;
Clarify that Worker Portal excludes $4500 from the total equity value of all non-excluded vehicles;
Incorporate policy regarding refunds that otherwise Medicaid eligible waiver recipients receive from their provider;
Incorporate policy regarding excluded STABLE accounts; and
Clarify existing policy.

MS 1885, Long Term Care Partnership Insurance Program, is revised to update procedures for entry on Worker Portal. It is also revised to remove reference to form PA-22, Resource Assessment, as the resource assessment is now entered on Worker Portal.

MS 1890, Annuities, is revised to update the procedures for requesting review of an annuity. It is further revised for clarity.

MS 1940, Jointly Held Resources, is revised for readability and clarity.

MS 1960, Lifetime Care Agreement, is revised to update the procedures for requesting a review of a lifetime care agreement.

MS 1990, Non-Recurring Lump Sum Income, is revised to clarify that Trusts, other than funeral trusts, are reviewed by the Office of Legal Services (OLS). It is further revised for clarity.

MS 2030, Vehicles, is revised to:

State that Worker Portal will exclude only one vehicle per person per reason;
State that Worker Portal excludes $4500 from the total equity value of all non-excluded vehicles;
Stateto enter the verified value of all vehicles on Worker Portal; and
Clarify existing policy.

MS 2031, Overview of Burial Reserves, is revised to remove references to form MA-36, Burial Designation as this form is no longer required. It is further revised for clarity and readability and to include policy regarding burial funds and cash set aside for burial.

MS 2033, Excluded Burial Items, is revised to change the title to Excluded Burial Spaces and Items and remove reference to form MA-36. It is further revised to incorporate policy that burial spaces can be excluded for immediate family members.

MS 2034, Burial Funds, is obsolete as the policy is incorporated into MS 2031.

MS 2035, Cash Set Aside for Burial Purposes, is obsolete as the policy has been incorporated into MS 2031.

MS 2055, Calculating Life Estate Transfers/Terminations, is revised to:

Change the title to Life Estate;
Explain how establishing or relinquishing a life estate affects Medicaid eligibility;
Clarify that some life estates are inherited and have no value;
Remove the requirement for DMS to review life estates that have been relinquished or sold; and
Correct the examples.

MS 2056, Life Estate Table, is revised to correct the Life Estate Table to include both the Life Estate Factor and the Remainder and list those factors appropriately. Previously the Remainder was incorrectly listed on the table as the Life Estate Factor.

MS 2070, Exceptions To Transfer Of Resources, is revised to incorporate procedures for requesting good cause and an undue hardship on Worker Portal. It is further revised for clarity and readability.

MS 2310, Long Term Care Insurance, is revised to remove reference to KAMES and revised for clarity.