1998 Minnesota Statutes

     256L.05 Application procedures. 

    Subdivision 1.    Application and information 
 availability.  Applications and other information must be made 
 available to provider offices, local human services agencies, 
 school districts, public and private elementary schools in which 
 25 percent or more of the students receive free or reduced price 
 lunches, community health offices, and Women, Infants and 
 Children (WIC) program sites.  These sites may accept 
 applications and forward the forms to the commissioner.  
 Otherwise, applicants may apply directly to the commissioner.  
 Beginning January 1, 2000, MinnesotaCare enrollment sites will 
 be expanded to include local county human services agencies 
 which choose to participate.  

    Subd. 1a.    Person authorized to apply on applicant's 
 behalf.  Beginning January 1, 1999, a family member who is age 
 18 or over or who is an authorized representative, as defined in 
 the medical assistance program, may apply on an applicant's 
 behalf. 

    Subd. 2.    Commissioner's duties.  The commissioner 
 shall use individuals' social security numbers as identifiers 
 for purposes of administering the plan and conduct data matches 
 to verify income.  Applicants shall submit evidence of 
 individual and family income, earned and unearned, such as the 
 most recent income tax return, wage slips, or other 
 documentation that is determined by the commissioner as 
 necessary to verify income eligibility.  The commissioner shall 
 perform random audits to verify reported income and 
 eligibility.  The commissioner may execute data sharing 
 arrangements with the department of revenue and any other 
 governmental agency in order to perform income verification 
 related to eligibility and premium payment under the 
 MinnesotaCare program. 

    Subd. 3.    Effective date of coverage.  The effective 
 date of coverage is the first day of the month following the 
 month in which eligibility is approved and the first premium 
 payment has been received.  As provided in section 256B.057, 
 coverage for newborns is automatic from the date of birth and 
 must be coordinated with other health coverage.  The effective 
 date of coverage for eligible newly adoptive children added to a 
 family receiving covered health services is the date of entry 
 into the family.  The effective date of coverage for other new 
 recipients added to the family receiving covered health services 
 is the first day of the month following the month in which 
 eligibility is approved or at renewal, whichever the family 
 receiving covered health services prefers.  All eligibility 
 criteria must be met by the family at the time the new family 
 member is added.  The income of the new family member is 
 included with the family's gross income and the adjusted premium 
 begins in the month the new family member is added.  The premium 
 must be received eight working days prior to the end of the 
 month for coverage to begin the following month.  Benefits are 
 not available until the day following discharge if an enrollee 
 is hospitalized on the first day of coverage.  Notwithstanding 
 any other law to the contrary, benefits under sections 256L.01 
 to 256L.18 are secondary to a plan of insurance or benefit 
 program under which an eligible person may have coverage and the 
 commissioner shall use cost avoidance techniques to ensure 
 coordination of any other health coverage for eligible persons.  
 The commissioner shall identify eligible persons who may have 
 coverage or benefits under other plans of insurance or who 
 become eligible for medical assistance. 

    Subd. 3a.    Renewal of eligibility.  Beginning January 
 1, 1999, an enrollee's eligibility must be renewed every 12 
 months.  The 12-month period begins in the month after the month 
 the application is approved.  

    Subd. 3b.    Reapplication.  Beginning January 1, 1999, 
 families and individuals must reapply after a lapse in coverage 
 of one calendar month or more and must meet all eligibility 
 criteria. 

    Subd. 4.    Application processing.  The commissioner of 
 human services shall determine an applicant's eligibility for 
 MinnesotaCare no more than 30 days from the date that the 
 application is received by the department of human services.  
 Beginning January 1, 2000, this requirement also applies to 
 local county human services agencies that determine eligibility 
 for MinnesotaCare.  To prevent processing delays, applicants 
 who, from the information provided on the application, appear to 
 meet eligibility requirements shall be enrolled.  The enrollee 
 must provide all required verifications within 30 days of 
 enrollment or coverage from the program shall be terminated.  
 Enrollees who are determined to be ineligible when verifications 
 are provided shall be disenrolled from the program. 

    Subd. 5.    Availability of private insurance.  The 
 commissioner, in consultation with the commissioners of health 
 and commerce, shall provide information regarding the 
 availability of private health insurance coverage to all 
 families and individuals enrolled in the MinnesotaCare program 
 whose gross family income is equal to or more than 200 percent 
 of the federal poverty guidelines.  This information must be 
 provided upon initial enrollment and annually thereafter. 

    HIST: 1986 c 444; 1987 c 403 art 2 s 63; 1988 c 689 art 2 s 
 137; 1992 c 549 art 4 s 6,19; 1993 c 247 art 4 s 6; 1994 c 625 
 art 8 s 72; art 13 s 3; 1995 c 234 art 6 s 10; 1996 c 451 art 5 
 s 10; 1997 c 225 art 1 s 9-11; 1997 c 251 s 26; 1998 c 407 art 5 
 s 26-31