Medicaid Policy
Medicaid Policy
Previous Policy (417-20 was previously found in multiple sections 403-4 until November 1, 2021)
A. Agent Orange Settlement Payments
1. Definition
a. Agent Orange settlement payments made in connection with the case of In re Agent Orange Product Liability Litigation come from a fund created by manufacturers of Agent Orange who agreed to pay into a settlement fund.
b. These payments began in March 1989.
c. Qualifying veterans receive at least one payment a year for the life of the program
d. Qualifying survivors of deceased veterans will receive a single lump sum payment.
2. Do not count interest earned on retained funds as income.
3. Exceptions to Exclusion:
a. Current monthly VA payments to the veteran or surviving spouse (pensions or compensation) may be based on a disability caused by exposure to Agent Orange; however, such payments are not from the Agent Orange Settlement and are countable income.
b. If the payments are made on behalf of or to a disabled child of a veteran who was exposed to Agent Orange, See 417-21 (Disaster Relief Funds).
4. See Sec. 521-25 for resource exclusion.
B. Radiation Exposure Compensation Trust Fund Payments
1. Definition
· These payments are made by the U.S. Government to individuals exposed to radiation during atmospheric nuclear testing in Nevada.
o These may be referred to as “down winders” payments or Radiation Exposure Compensation Trust Fund Payments.
2. Do not count interest on retained funds as income.
3. See Sec. 521-24 for resource exclusion.
C. Disaster Relief and Emergency Assistance Act
1. Definition
· Payments can be made under the federal Disaster Relief and Emergency Assistance Act and other assistance can be provided under a federal statute because of a catastrophe which is declared a major disaster by the President of the United States (i.e. disaster related Unemployment Compensation).
2. In addition to assistance from the federal government, exclude from income, funds received from a State or local government, or a disaster assistance organization, when paid to an individual due to a major disaster as ordered by the President.
3. Exclude as income any interest earned on these funds.
4. See 521-31 for resource exclusion.
D. Federal Pandemic Unemployment Compensation
1. The CARES act, issued on March 27, 2020, allows for people who might not otherwise be eligible for unemployment compensation to receive payments, by including, among other things, provisions for temporary coverage of individuals who have exhausted their entitlement to regular unemployment compensation and who are self-employed or have limited recent work history.
· These unemployment compensation payments will be countable for all Medicaid programs
2. It also provides individuals who are collecting unemployment compensation benefits with an additional $600 in Federal benefits per week for weeks of unemployment ending on or before July 31, 2020.
· These additional payments will be excluded income in determining all Medicaid programs.
3. See 521-46 for asset policy.
E. Settlements Paid to Hemophilia Patients (and others) Infected with HIV
1. A number of class action suits were settled on behalf of people with hemophilia who became infected with HIV from blood products received between 1978 and 1985.
a. Settlements also cover spouses and children who became infected with HIV.
b. The companies involved agreed to make settlement payments to people in this class or to certain heirs of such persons in the event such person is deceased. The original class action suit is called "Susan Walker v. Bayer Corporation, et al," 96-C-5024 (N.D. Ill.)
2. Payments in the settlement of a class action lawsuit made to a person with hemophilia infected with HIV, or to a person infected by a person with hemophilia with HIV, or to an heir of such person are not counted as income.
3. See 521-33 for resource exclusion.
F. Victim’s Compensation Payments
1. Do not count as income, payments made from a fund established by a state to aid victims of a crime.
2. Interest earned on retained funds does not count as income.
3. For resource exclusion, see Section 521-26.
G. Energy Employees Occupational Illness Compensation Program Act (EEOICP)
1. Definition
a. The EEOICP makes lump sum payments and reimbursement of medical expenses to employees of the Department of Energy (DOE) or of private companies under contract with DOE, who suffer from specific diseases because of their work in the nuclear weapons industry, and designated beryllium workers.
· Survivors of these employees may also receive payments.
b. There are two parts to this law, Part B and Part E. Each one has different effective dates, illness criteria and medical/compensation allowances.
i. Part B is effective July 31, 2001 and includes compensation of:
· $150,000 for a covered employee or his or her survivors, and
· $50,000 for a covered uranium worker or his or her survivors who previously received $100,000 compensation under the Radiation Exposure Compensation Act.
ii. Part E is effective October 28, 2004, and includes variable compensation up to $250,000 based on wage loss, medical expenses, impairment, and survivorship.
iii. Some individuals who receive a payment under EEOICP may also receive a payment under the Radiation Compensation Act.
· Eligible individuals may include those exposed to toxic substances such as solvents, chemicals, acids, and metals, in addition to those exposed to radiation.
2. Policy for Treatment of Payments
· The income exclusion includes lump sum payments made under the EEOICP, including reimbursement for medical expenses received by the affected employee or by a survivor.
3. Verification of EEOICP Income
a. Review Department of Labor (DOL) documents the individual has, or
b. Contact the local DOL district office. A list of the DOL district offices and telephone numbers is included on the DOL website at: https://www.dol.gov/agencies/whd/contact/local-offices .
4. Exclude from income, interest earned on retained funds.
5. See 521-41 for resource exclusion rules.