Minnesota Legislature
HF 4273
as introduced - 92nd Legislature (2021 - 2022) Posted on 03/17/2022 05:34pm
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 03/14/2022 |
Current Version - as introduced
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A bill for an act
relating to human services; modifying medical assistance eligibility requirements
of employed persons with disabilities; amending Minnesota Statutes 2020, section
256B.057, subdivision 9.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2020, 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:
(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;
(2) meets the asset limits in paragraph (d); and
(3) pays a premium and other obligations under paragraph (e).
(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 or assets shall be disregarded for purposes of eligibility and premium
determinations.
(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 and the
enrollee must pay all calculated premium costs for continued eligibility.
(d) For purposes of determining eligibility under this subdivision, a person's assets must
not exceed deleted text begin $20,000deleted text end new text begin $40,000new text end , excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh
plans, and pension plans;
(3) medical expense accounts set up through the person's employer; and
(4) spousal assets, including spouse's share of jointly held assets.
new text begin
(e) Beginning July 1, 2023, and each July 1 thereafter, the commissioner shall adjust
the asset limit in paragraph (d) by the percent change in the CPI-U from June 1 of the prior
calendar year to June 1 of the current calendar year.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under clause (5).
(1) An enrollee must pay the greater of a $35 premium or the premium calculated deleted text begin based
ondeleted text end new text begin by applying the following sliding premium fee scale tonew text end the person's gross earned and
unearned income and the applicable family size deleted text begin 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 new text begin :
new text end
new text begin
(i) for households with income less than 200 percent of federal poverty guidelines, the
premium shall be zero percent of income;
new text end
new text begin
(ii) for households with income from 200 to 250 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at zero percent of income and increase to 2.5
percent;
new text end
new text begin
(iii) for households with income from 250 to 300 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at 2.5 percent of income and increase to 4.5 percent;
new text end
new text begin
(iv) for households with income from 300 to 400 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at 4.5 percent of income and increase to six percent;
new text end
new text begin
(v) for households with income from 400 to 500 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at six percent of income and increase to 7.5 percent;
and
new text end
new text begin
(vi) for households with income greater than 500 percent of federal poverty guidelines,
the premium shall be 7.5 percent of income.
new text end
new text begin
(2) When determining an enrollee's income for the purposes of determining the premium
amount, the local county agency must use either the enrollee's gross earned and unearned
income from the previous 30 days or the monthly average from the previous calendar year,
whichever is lower.
new text end
new text begin
(3) Prior to determining an enrollee's income for the purposes of determining the premium
amount, the local county agency must subtract the value of any Medicare premiums,
coinsurance, and deductibles not reimbursed under this chapter.
new text end
deleted text begin (2)deleted text end new text begin (4)new text end 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 begin (3)deleted text end new text begin (5)new text end 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 begin (4)deleted text end new text begin (6)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)deleted text end new text begin (7)new text end 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 begin (f)deleted text end new text begin (g)new text end A person's eligibility and premium shall be determined by the local county agency.
Premiums must be paid to the commissioner. All premiums are dedicated to the
commissioner.
deleted text begin (g)deleted text end new text begin (h)new text end Any required premium shall be determined at application and redetermined at
the enrollee's deleted text begin six-monthdeleted text end new text begin annualnew text end income review or when a change in income or household
size is reported. Enrollees must report any change in income or household size within ten
days of when the change occurs. 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 deleted text begin six-monthdeleted text end new text begin annualnew text end review.
deleted text begin (h)deleted text end new text begin (i)new text end 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.new text begin
Enrollees who fail to pay a premium must: be contacted by phone or in person and directly
spoken to by the local county agency within 30 days following each past due date, be notified
of the enrollee's past due premium payments, and be offered either a repayment plan or an
alternative medical care coverage option for which the enrollee is eligible. A past due notice
must not include a threat of termination of medical assistance unless the commissioner
provides the notice more than 120 days after the initial past due notice.
new text end
deleted text begin (i)deleted text end new text begin (j)new text end Nonpayment of the premium deleted text begin shalldeleted text end new text begin after 180 calendar days will new text end 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 begin (j)deleted text end new text begin (k)new text end For enrollees deleted text begin whose income does not exceed 200 percent of the federal poverty
guidelinesdeleted text end new text begin who are eligible under this subdivisionnew text end and who are also enrolled in Medicare,
the commissioner shall reimburse the enrollee for Medicare Partnew text begin A and Medicare Partnew text end B
premiumsnew text begin , Part A and Part B coinsurance and deductibles, and cost-effective premiums for
enrollment with a health maintenance organization or a competitive medical plan under
section 1876 of the Social Security Actnew text end under section 256B.0625, subdivision 15, paragraph
(a).new text begin 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 were a medical assistance recipient with Medicare
coverage. Increases in benefits under Title II of the Social Security Act must not be counted
as income for purposes of this subdivision until July 1 of each year.
new text end