Medicaid Policy                                                                 

415-13 Countable Payments to American Indians/Alaska Natives

Effective Date: November 1, 2021

Previous Policy (415-13 was previously found in 403-16 until November 1, 2021)

 

General Requirements

 

This policy applies regardless of the tribe to which the American Indians/Alaska Natives belongs. To determine how these payments count for MAGI-based programs, see 440-4.

1.       Count as income any monies paid by the tribe from funds that are not held in trust by the Secretary of the Interior. This includes payments from the proceeds of tribal run businesses. Examples are revenues from tribal run businesses such as:

·       Gambling managed by the tribes

·       Sales of items not held in trust, or

·       Storage of nuclear waste on tribal lands

2.       Tribal general assistance payments may be made by either the Bureau of Indian Affairs (BIA) or from tribal funds. Find out the source of the payments being made to the individual. Assistance payments from the BIA (or which include federal funds from BIA) are countable income for Medicaid. For ABD and LTC, do not allow the $20 disregard from general assistance payments from the BIA. Assistance payments directly from the tribe consisting only of tribal funds do not count as income. Request documents verifying the source of the payments, or contact BIA or the tribe.