SR 11-04 Dated 04/11

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases an extension in the eligibility period from 6 months to 12 months for certain recipients of the Medicare Savings Program (MSP), which includes the Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB & SLMB135), and Qualified Disabled and Working Individual (QDWI) programs.

Currently, QMB, QWDI, SLMB, and SLMB135 cases are automatically allowed a 12-month redetermination period per Adult Assistance Manual (AAM) 155, REDETERMINATION. However, if the MSP case involves multiple programs of assistance, redeterminations of assistance for all programs are aligned to coincide with the most frequent redetermination required by policy per AAM 127, LENGTH OF ELIGIBILITY. Failure or refusal to complete the redetermination process at the more frequent redetermination, results in most programs of assistance being terminated. As of the effective date of this SR, extend the MSP redetermination date out an additional 6 months for cases whose Food Stamp and/or Child Care benefits close due to the household’s failure or refusal to complete the mail-in or face-to-face redetermination process. This extension in the eligibility period ensures a full 12-months of benefits for MSP-eligible recipients, but only applies in the following circumstances:

·   the case cannot be receiving any category of financial assistance or any category of In and Out medical assistance at the time of closing;

·   the only other categories of assistance the case can be receiving at the time of closing other than MSP is Food Stamp assistance, including expedited Food Stamp benefits, Healthy Kids Gold (HKG-185 and HKG-300) or Healthy Kids Silver (HKS) assistance, or Child Care assistance; and

·   the reason the Food Stamp or Child Care assistance is ending can only be due to failure or refusal to complete the redetermination process and the reason the Expedited Food Stamp assistance is ending can only be failure to provide verification. If, for example, the case is closing due to being over income, the changed income information must be applied to all categories of assistance the case is receiving, even if this new information results in termination of MSP.

POLICY

Extend the redetermination date out an additional 6 months for recipients of the Medicare Savings Program (MSP), which includes the Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB & SLMB135), and Qualified Disabled and Working Individual (QDWI) programs, when the following applies:

·   the case is not receiving any category of financial assistance or any category of In and Out medical assistance at the time of closing;

·   the only other categories of assistance the case is receiving at the time of closing other than MSP assistance, is Food Stamp assistance, including expedited Food Stamp benefits, HKG or HKS assistance, or Child Care assistance; and

·   the household fails or refuses to complete the mail-in or face-to-face redetermination process for Food Stamp or Child Care assistance. The reason Food Stamps or Child Care benefits is ending can only be due to failure or refusal to complete the redetermination process. The reason the Expedited Food Stamp assistance is ending can only be due to failure to provide verification. If, for example, the case is closing due to being over income, the changed income information must be applied to all categories of assistance the case is receiving, even if this new information results in termination of Medicare Savings Program.

This extension in the eligibility period ensures a full 12-months of benefits for MSP recipients.

DISTRICT OFFICE AND NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

New HEIGHTS will incorporate the changes in this SR when funding and resources permit. Until the automation of the policy becomes available, when a household fails or refuses to complete the mail-in or face-to-face redetermination process for Food Stamps or Child Care, Family Service Specialists need to manually extend the redetermination date of the MSP program out an additional 6 months to ensure that the client receives a full year of MSP. To manually extend the redetermination date for MSP cases that are open for FS/CC/MSP when the recipient has failed to complete the redetermination process, do the following:

·   Once the FS and CC auto closes at the end of the month, launch to any overdue redeterminations listed from the "Dashboard" screen.

·   Double click on any rows that are showing as MA only. This will bring up the Inquiry screen.

·   Check to be sure that FS and CC closed for failure to complete the redetermination process and that the MSP program is open.

·   Go to the "Eligibility Results, Eligibility Review Information" screen, enter the appropriate override redetermination date and select an "Override Method" of "Paper."

To manually extend the redetermination date for MSP cases that are open for MSP and received expedited Food Stamps but expedited Food Stamp benefits are closing due to failure to provide verification, do the following:

·   After confirming, click on the "Redetermination Date" button and override the redetermination date, OR go to the "Eligibility Results, Eligibility Review Information" screen as stated above.

·   Enter the appropriate redetermination date and select an "Override Method" of "Paper."

POLICY MANUAL REVISIONS

Revised Adult Assistance Manual Topics

PART 155.03 Termination at Redetermination

Glossary M-words

IMPLEMENTATION

The policy released in this SR is effective April 29, 2011.

TRAINING

No special training is planned.

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective May 2, 2011. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Adult Assistance Manual.

DFA/JT:s