Section 409-12 Deduction for Dependent Family Members:
Removes the requirement that a waiver or nursing home client be married to allow an income deduction for dependent family members;
Removes the requirement that a family member has to either live with the client's community spouse or with the waiver client;
Establishes two different family member allowances
the BMS for 1 when the client resides in a nursing home, or
the Spousal impoverishment rules amount for a family member when the client is on a home and community based waiver.
Section 389 Tech Dependent Waiver:
Earned income deduction changing to SGA amount.
900-3 Open Enrollment Periods: Medicaid policy for describing what is an application is extended to PCN policy.
402 What Is Not Income: Adding payments received from Clinical Trial participation as non-countable income
703-2 Date of Application: Change date of application for applications received via online, fax (paper applications received in the office or outreach to align policy with DWS.
1004 Income Standards, 1004-4 Determination of Income Eligibility: For the UPP program, we are increasing the income limit from 150% FPL to 200% FPL for adults.
1008 Certification Period, 1008-1 Conducting an Eligibility Review, 1009-1 Reportable Changes: The UPP program will no longer conduct 6 month reviews of insurance coverage. Instead, DOH will verify insurance coverage quarterly with employers.
386-2 General Requirements for the New Choices Waiver: Reduction of minimum age from 21 to 18 years of age.
403-4 Unearned Income Exclusions, 521-5 Indian Land or Accounts Held in Trust: Payments from IIM accounts are exempt as income. Assets held in those accounts are not countable.
405-4 Earned Income Exclusions: Workforce Investment Act income (WIA) is countable if it is earned/paid as wages. If the income is paid as day care or social services it is not countable.
343 Slight reformatting changes and fixed a typo. Removed a "Tip" by adding the language to the corresponding bullet.
343-2 The reporting requirements for the Second Report have been added to policy (they are the same as for the Third Report). Added more links to 343-3 & 343-4 (Good Cause reasons) to the 2nd & 3rd Report sections. Some areas have been re-worded for clarification purposes.
343-5 Reformatted and made the first example unhidden.
Added clarifying language that sibling to sibling deeming of assets is prohibited. Noted the two exceptions: LIFC and when no child is eligible for Poverty Level Medicaid.
340-5 Whose Income and Assets to Count
419 Income Calculation for PW, etc
575 Whose Assets to Count
903-4 and 903-8 have been combined. The new section 903-4 better defines employer sponsored health insurance and clarifies using the employer-sponsored least expensive plan or the UHE default plan when determining the employee cost of coverage.
1003-4 and 1003-8 have been combined. The new section 1003-4 better defines employer sponsored health insurance and clarifies using the employer-sponsored least expensive plan or the UHE default plan when determining the employee cost of coverage.
1010 Program Benefits: This change clarifies that regardless of the cost of dental insurance, the reimbursement will be $20.00.
Contact information on the Welcome Page has been updated.
The Long Term Care Bureau (LTC) has changed its name to the Bureau of Authorization and Community Based Services (BACBS).
Section 414-1 Short-Term Stay for Unmarried Clients: There is a conflict between the policy and the rule. In a hearing the rule will trump policy. An unmarried client or a client whose spouse lives in a medical institution is allowed to keep the short-term personal needs allowance of $382 if their doctor verifies their stay in an institution is expected to be six months or less.
903-3 and 903-9: Part-time students are eligible for PCN regardless if health insurance is available through the college or university.
904-4, 1004-4 Determination of Income Eligibility: Workers should not factor annualized income for the PCN and UPP programs. We removed all language from policy relating to factoring for these programs. Updated examples.
Medicaid Section 350 and 356: Children under the age of 19 may be eligible for Presumptive Eligibility (PE) for Medicaid or CHIP. When a child exits Foster Care or JJS and returns to a home, DHS determines the PE for other children in the household who are not currently receiving Medicaid or CHIP.
Presumptive eligibility for children is based on customer’s declaration of income, citizenship/alien status, and household size. There is not any asset test. For CHIP, child must not be enrolled in any health insurance.
One application is used for both PE and regular medical. Once PE is determined, DHS forwards this application to DWS to look at eligibility for regular Medicaid or CHIP.
721-1: Reviews for selected programs will be completed without client participation if there are no changes reported by client or worker resources.
903-4 and 1003-4 Access to Employer Sponsored Health Insurance: Deductibles will no longer be included in the calculation to determine the cost of health insurance coverage for PCN and UPP.
1003-1, 1003-4 and 1003-8: Adding information regarding UPP referrals and eligibility through the Utah Health Exchange
PCN open enrollment for all adults: March 19 - March 30, 2012
The following tables have updated income limits.
TABLE II - Aged, Blind and Disabled Income Limits and Other Important Figures
TABLE V - Sponsor Deeming
TABLE VII - Income Limits for Medical Assistance & Medicare
TABLE VII-A - Poverty Guideline Tables
900-3, 906, 908, 908-1, 909: PCN reviews/re-certifications are new applications and follow application rules. Due Process months will not be used for PCN re-certifications.
1009-2 Income Changes: A clarification: When income is reported to decrease during an UPP certification period, workers should only determine eligibility for Medicaid if clients request an income or Medicaid determination.
Updated Table II figures for 2012
Sections 371-3, 380, 386-2, 521-1 (Family, ABD and Long-term Care) regarding substantial home equity were updated.