BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.82.1107 pertaining to medically needy living allowance deduction

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO: All Concerned Persons

 

            1. On August 29, 2022, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider the proposed amendment of the above-stated rule. Interested parties may access the remote conferencing platform in the following ways: 

            (a) Join Zoom Meeting at: https://mt-gov.zoom.us/j/84583832603?pwd=TThxR0JhdmlUM2JWNWp3ajhZRkI0UT09, Meeting ID: 845 8383 2603, and Password: 153047; or

(b) Dial by Telephone: +1 646 558 8656, Meeting ID: 845 8383 2603, and Password: 153047. Find your local number: https://mt-gov.zoom.us/u/k7E1VxEJM.

 

2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact the Department of Public Health and Human Services no later than 5:00 p.m. on August 15, 2022, to advise us of the nature of the accommodation that you need. Please contact Kassie Thompson, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected].

 

3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

 

37.82.1107 INCOME ELIGIBILITY, NONINSTITUTIONALIZED MEDICALLY NEEDY (1) Medically needy income eligibility for SSI non-institutionalized and family-related persons and families will be computed using a one month prospective budget period.

(a) For groups covered under ARM 37.82.1101(1)(a) through (1)(e), monthly countable income will be determined using family-related Medicaid income requirements, in particular those with respect to prospective budgeting and earned income disregards, set forth in the Family Medicaid Program Policy Manual, sections 601-1 and 602-1.

(i) In the case of individuals whose income must be deemed when determining eligibility, the family-related Medicaid income requirements contained in the Family Medicaid Program Policy Manual, section 603-1 will be used.

(ii) remains the same.

(b) For groups covered under ARM 37.82.1101(4)(a) and (b), countable income will be determined using the SSI income requirements set forth in 20 CFR, part 416, subpart K, as amended through April 1, 2001 January 1, 2022, which contains the SSI criteria for evaluating income, including the income of financially responsible relatives. The department hereby adopts and incorporates by reference 20 CFR, part 416, subpart K, as amended through April 1, 2001 January 1, 2022. A copy of these federal regulations may be obtained from the Department of Public Health and Human Services, Human and Community Services Division, Public Assistance Bureau, 111 N. Jackson St. 1500 E. 6th Ave., P.O. Box 202925, Helena, MT 59620-2925.

(i) and (2) remain the same.

(3) When an otherwise eligible individual or family covered under ARM 37.82.1101 has countable income which exceeds the medically needy income level, the individual or family will become eligible:

(a) remains the same.

(b) after a medical expense incurment is satisfied. The incurment is equal to the difference between the countable income and the medically needy income limit for the family size, less a living allowance deduction of $269.  The living allowance deduction will adjust each year with the annual Social Security Cost of Living Adjustment (COLA). Eligibility will extend to the end of the budget period. The only medical expenses which may be used to meet the incurment requirement are:

(i) through (6) remain the same.

 

AUTH: 53-2-201, 53-4-212, 53-6-113, 53-6-402, MCA

IMP: 53-2-201, 53-4-231, 53-6-101, 53-6-131, 53-6-402, MCA

 

4. STATEMENT OF REASONABLE NECESSITY

 

Adding an annual Social Security Cost of Living Adjustment (COLA) to the living allowance deduction is necessary so that Montanans can put any additional funds they receive through the COLA toward non-health care related living expenses, instead of into a higher monthly incurment to receive Medicaid coverage.

 

The proposal also makes a changes to the language in ARM 37.82.1107(1), updates the name of the manual referenced in ARM 37.82.1107(1)(a) and (a)(i), and updates the address at which certain materials can be obtained in ARM 37.82.1107(1)(b).

 

Fiscal Impact

 

Annually increasing the living adjustment deduction by COLA will benefit approximately 1,350 disabled and aged individuals who receive health care coverage through the medically needy program monthly. The COLA has increased approximately $15 a month each year over the last 10 years. The department estimates with increased inflation, the COLA will increase by approximately $50 in 2023 and each year thereafter. This equates to approximately $810,000 a year that these Medicaid recipients can put towards living expenses instead of an increased incurment.

 

5. The department intends for the proposed amendments to be effective retroactive to January 1, 2022.

 

6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kassie Thompson, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., September 2, 2022.

 

7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

 

9. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

10. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rule will not significantly and directly impact small businesses.

 

 

 

/s/ HEIDI SANDERS                                   /s/ CHARLES T. BRERETON                   

Heidi Sanders                                             Charles T. Brereton, Director

Rule Reviewer                                            Department of Public Health and Human Services

 

 

Certified to the Secretary of State July 26, 2022.