HF 1384

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/01/2023 10:50am

A bill for an act
relating to human services; requiring notice of the medical assistance program for
employed persons with disabilities; modifying medical assistance eligibility
requirements for employed persons with disabilities; amending Minnesota Statutes
2022, sections 256B.04, by adding a subdivision; 256B.056, subdivision 3;
256B.057, subdivision 9.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2022, section 256B.04, is amended by adding a subdivision
to read:

new text begin Subd. 26. new text end

new text begin Notice of employed persons with disabilities program. new text end

new text begin At the time of initial
enrollment and at least annually thereafter, the commissioner shall provide information on
the medical assistance program for employed persons with disabilities under section
256B.057, subdivision 9, to all medical assistance enrollees who indicate they have a
disability.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:

Subd. 3.

Asset limitations for certain individuals.

(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or family may
accrue interest on these amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability deleted text begin , to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d) deleted text end ;

(6) a designated employment incentives asset account is disregarded when determining
eligibility for medical assistance for a person age 65 years or older under section 256B.055,
subdivision 7. An employment incentives asset account must only be designated by a person
who has been enrolled in medical assistance under section 256B.057, subdivision 9, for a
24-consecutive-month period. A designated employment incentives asset account contains
qualified assets owned by the person and the person's spouse in the last month of enrollment
in medical assistance under section 256B.057, subdivision 9. Qualified assets include
retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's
other nonexcluded assets. An employment incentives asset account is no longer designated
when a person loses medical assistance eligibility for a calendar month or more before
turning age 65. A person who loses medical assistance eligibility before age 65 can establish
a new designated employment incentives asset account by establishing a new
24-consecutive-month period of enrollment under section 256B.057, subdivision 9. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions
in section 256B.059; and

(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) No asset limit shall apply to persons eligible under deleted text begin section deleted text end new text begin sections new text end 256B.055,
subdivision 15 new text begin , and 256B.057, subdivision 9 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:

Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid for
a person who is employed and who deleted text begin :
deleted text end

deleted text begin (1) deleted text end but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program deleted text begin ;
deleted text end

deleted text begin (2) meets the asset limits in paragraph (d); and
deleted text end

deleted text begin (3) pays a premium and other obligations under paragraph (e) deleted text end .

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income deleted text begin or assets deleted text end shall be disregarded for purposes of eligibility deleted text begin and premium
determinations deleted text end .

(c) After the month of enrollment, a person enrolled in medical assistance under this
subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a medical
condition, as verified by a physician, advanced practice registered nurse, or physician
assistant; or

(2) loses employment for reasons not attributable to the enrollee, and is without receipt
of earned income may retain eligibility for up to four consecutive months after the month
of job loss. To receive a four-month extension, enrollees must verify the medical condition
or provide notification of job loss. All other eligibility requirements must be met deleted text begin and the
enrollee must pay all calculated premium costs for continued eligibility deleted text end .

deleted text begin (d) For purposes of determining eligibility under this subdivision, a person's assets must
not exceed $20,000, excluding:
deleted text end

deleted text begin (1) all assets excluded under section 256B.056;
deleted text end

deleted text begin (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh
plans, and pension plans;
deleted text end

deleted text begin (3) medical expense accounts set up through the person's employer; and
deleted text end

deleted text begin (4) spousal assets, including spouse's share of jointly held assets.
deleted text end

deleted text begin (e) All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under clause (5).
deleted text end

deleted text begin (1) An enrollee must pay the greater of a $35 premium or the premium calculated based
on the person's gross earned and unearned income and the applicable family size using a
sliding fee scale established by the commissioner, which begins at one percent of income
at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for
those with incomes at or above 300 percent of the federal poverty guidelines.
deleted text end

deleted text begin (2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.
deleted text end

deleted text begin (3) All enrollees who receive unearned income must pay one-half of one percent of
unearned income in addition to the premium amount, except as provided under clause (5).
deleted text end

deleted text begin (4) deleted text end new text begin (d) new text end Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year.

deleted text begin (5) Effective July 1, 2009, American Indians are exempt from paying premiums as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
deleted text end

deleted text begin (f) deleted text end new text begin (e) new text end A person's eligibility deleted text begin and premium deleted text end shall be determined by the local county agency.
deleted text begin Premiums must be paid to the commissioner. All premiums are dedicated to the
commissioner.
deleted text end

deleted text begin (g) Any required premium shall be determined at application and redetermined at the
enrollee's six-month income review or when a change in income or household size is reported. deleted text end new text begin
(f) new text end Enrollees must report any change in income or household size within ten days of when
the change occurs. deleted text begin A decreased premium resulting from a reported change in income or
household size shall be effective the first day of the next available billing month after the
change is reported. Except for changes occurring from annual cost-of-living increases, a
change resulting in an increased premium shall not affect the premium amount until the
next six-month review.
deleted text end

deleted text begin (h) Premium payment is due upon notification from the commissioner of the premium
amount required. Premiums may be paid in installments at the discretion of the commissioner.
deleted text end

deleted text begin (i) Nonpayment of the premium shall result in denial or termination of medical assistance
unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse
for the enrollee's failure to pay the required premium when due because the circumstances
were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall
determine whether good cause exists based on the weight of the supporting evidence
submitted by the enrollee to demonstrate good cause. Except when an installment agreement
is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must
pay any past due premiums as well as current premiums due prior to being reenrolled.
Nonpayment shall include payment with a returned, refused, or dishonored instrument. The
commissioner may require a guaranteed form of payment as the only means to replace a
returned, refused, or dishonored instrument.
deleted text end

deleted text begin (j) deleted text end new text begin (g) new text end For enrollees deleted text begin whose income does not exceed 200 percent of the federal poverty
guidelines deleted text end new text begin who are: (1) eligible under this subdivision new text end and deleted text begin who are deleted text end also enrolled in Medicare deleted text begin , deleted text end new text begin ; new text end
new text begin and (2) not eligible for medical assistance reimbursement of Medicare premiums under
subdivision 3, 3a, 3b, or 4, new text end the commissioner shall reimburse the enrollee for Medicare new text begin part
A and Medicare new text end part B premiums deleted text begin under section 256B.0625, subdivision 15, paragraph (a). deleted text end new text begin
and part A and part B coinsurance and deductibles. Reimbursement of the Medicare
coinsurance and deductibles, when added to the amount paid by Medicare, must not exceed
the total rate the provider would have received for the same service or services if the person
was receiving benefits as a qualified Medicare beneficiary.
new text end

new text begin (h) The commissioner must permit any individual who was disenrolled for nonpayment
of premiums previously required under this subdivision to reapply for medical assistance
under this subdivision and be reenrolled if eligible without paying past due premiums.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end