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SF 238

as introduced - 89th Legislature (2015 - 2016) Posted on 03/04/2015 06:26pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; reducing premium payments for the medical
assistance employed persons with disabilities program; amending Minnesota
Statutes 2014, section 256B.057, subdivision 9.


Section 1.

Minnesota Statutes 2014, section 256B.057, subdivision 9, is amended to

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

(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; 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 $20,000, 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.

(e) 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 deleted text begin$65deleted text endnew text begin $35new text end 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.

(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.

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

(4) 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.

(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.

(f) 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.

(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. 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 six-month review.

(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.

(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
deleted text beginif the requirementsdeleted text endnew text begin asnew text end specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
Ddeleted text begin, are met. 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
deleted text text begin Persons who have been denied
enrollment or disenrolled for nonpayment of a premium and who have an installment
program accepted by the commissioner may reenroll.
new text end 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.

(j) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).

new text end

new text begin For enrollees in the medical assistance employed persons with disabilities
(MA-EPD) program who paid all or part of the premium increase that went into effect
October 1, 2014, the commissioner shall reduce the amount of the premiums due
beginning July 1, 2015, that each enrollee owes until the amount of the increase paid
between October 1, 2014, and June 30, 2015, has been credited against the premiums due.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015.
new text end