DHHS - Medicaid Policy Manual

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Obsolete 0122 - What's New

December 2021

348-3 Adult Expansion Employer-Sponsored Insurance Premium Reimbursement 348-3.1 ESI Enrollment Requirements 348-3.2 Health Insurance Coverage 348-3.3 How to Calculate an ESI Premium Reimbursement 348-3.4 Disenrollment Period For Adult Expansion	Clarifying policy for an ESI reimbursement.
Table XVII Targeted Adult Medicaid (TAM) Agencies	Added TAM agency to complete the 43A.

November 2021

400 sections	Rewriting all 400 income sections for organization and incorporating how to determine household size.
Glossary	Broke up into 4 sections with an alpha split.
205-2 Qualified Aliens	Adding policy for Afghanistan Parolees
731-8 Verification for Targeted Adult Medicaid (TAM)	Adding a new referral form is required at review for the Justice Involved on parole or probation.
Table XVII Targeted Adult Medicaid (TAM) Agencies	Added TAM agency to complete the 43A.
Table XIV Hospitals Authorized to Approve HPE	Adding new HPE provider.

October 2021

370-1 Eligible for a Medicaid Program	Removing Parent Care Taker Relative from list of programs eligible for nursing home benefits.
721-1 Conducting an Eligibility Review	Clarifying when to do an ex parte review on Adult Expansion.
205-6 Emergency Medicaid	Adding 4-month Extended Medicaid and 12-Month Transitional Medicaid to the list of Medicaid programs not eligible for Emergency Services.
Table II-A Long Term Care Institutional and Waiver Income Limits and Other Important Figures	Updating the utility allowances for shelter deductions.

September 2021

346 Targeted Adult Medicaid (TAM) 731-8 Verification for Targeted Adult Medicaid (TAM)	Reorganzing the Chronically Homeless subgroup and verification chart.
1010 Program Benefits	Adding how to calculate an UPP payment.
348 Adult Expansion 348-2 Community Engagement 731-9 Community Engagement Acceptable Verification COVID 19 Questions and Answers	Removing the Community Engagement requirement from Adult Expansion.
215-6 Residents of Non-Medical Institutions	Clarifying when home confinement fits the definition of incarceration.
COVID 19 Questions and Answers	Adding guidance on when an ex parte review can be completed.

August 2021

205-2 Qualified Aliens 205-6 Emergency Medicaid	Adding qualified alien guidance for the Citizens of the Freely Associated States (COFA).
1000 Utah's Premium Partnership For Health Insurance (UPP). 1003-4 Access to Employer-Sponsored Health Insurance	Removing references to Avenue H .
503-2 When Assets Must Be Below the Asset Limit	Updating language to include all types of financial accounts.

July 2021

380 Home and Community Based (HCB) Waiver Programs 388 Limited Supports Waiver (LSW) 388-1 General Requirements For The Limited Supports Waiver (LSW) 388-2 Limited Supports Waiver Coverage Groups	Adding the new 1915(c) Limited Supports Waiver.
1010 Program Benefits	UPP reimbursement increase for adults.
Table II-A Long Term Care Institutional and Waiver Income Limits and Other Important Figures	Updating Minium Spousal Needs Standard and Shelter Standard.

May 2021

Table XVII Targeted Adult Medicaid (TAM) Agencies	Added TAM agency to complete the 43A. Updated TAM agency name change.
COVID 19 Questions and Answers	Adding additional guidance on resource.

March 2021

Table II Aged, Blind and Disabled Income Limits and Other Important Figures Table II-A Long Term Care Institutional and Waiver Income Limits and Other Important Figures Table V Sponsor Deeming Table VII Income Limits for Medical & Medicare Cost-Sharing Programs Table VII-A Medicaid Work Incentive Income And Premium Tests Table VII-B 5% Federal Poverty Level Deduction Amount	Updating Federal Poverty Rates.
346 Targeted Adult Medicaid (TAM) 715 Certification Period	Clarifying retroactive months and the certification period.
Table XVII Targeted Adult Medicaid (TAM) Agencies	Added TAM agency to complete the 43A.
COVID 19 Questions and Answers	Adding additional guidance on resource.

February 2021

Table XVII Targeted Adult Medicaid (TAM) Agencies	Added TAM agencies to complete the 43A, and what questions the agencies can complete.
COVID 19 Questions and Answers	Adding additional guidance on resource.
Table XIX IMD's Licensed to Provide Treatment for Serious Mental Illness	Added Salt Lake Behavioral Health Hospital as an IMD Licensed to Provide Treatment for Serious Mental Illness.
348-3 Adult Expansion Employer-Sponsored Insurance Premium Reimbursement 348-3.2 Health Insurance Coverage 1003-1 Definitions 1010 Program Benefits	Adding lifetime maximum to the definition of a Qualified Health Plan. Clarifying that ESI and UPP premium reimbursements cannot be made for Health Savings Account or Flexible Spending Account.
356 Presumptive Eligibility (PE)	Adding requirement for all PE providers to use the Presumptive Eligibility Portal to administer HPE or BYB.
1003-2 Health Insurance Coverage	Clarifying that UPP premium reimbursements cannot be made for a student health plan.
450-4 Calculating Income for MAGI-Based Programs	Updating policy to state the 5% income deduction does not apply to Targeted Adult Medicaid (TAM) program.

January 2021

Table II Aged, Blind and Disabled Income Limits and Other Important Figures Table II-A Long Term Care Institutional and Waiver Income Limits and Other Important Figures Table VII Income Limits for Medical & Medicare Cost-Sharing Programs Table XI Pickle Reduction Figures	Updating 2021 COLA figures.
215-5 Residents of Institutions for Mental Disease (IMDs) 320-1 Eligibility for Medicare Cost-Sharing Table XIX IMD's Licensed to Provide Treatment for Serious Mental Illness	Adding guidance on who qualifies for Behavioral Health IMD coverage.