Revisions

21-3, September Quarterly Revision

Revision Notice 21-3; Effective September 1, 2021

 

Archived Revision 21-2; Effective June 1, 2021
Archived Revision 21-1; Effective March 1, 2021
Archived Revision 20-4; Effective December 1, 2020
Archived Revision 20-3; Effective September 1, 2020

Revisions

The following sections were revised in the Medicaid for the Elderly and Persons with Disabilities (MEPD) Handbook:

Sections Section Title Change
B-9000
C-2000
I-5000
J-7000
R-4000
Denials;
Confidential Nature of the Case Record;
Calculation of Penalty Period;
Income for Eligibility and Co-Payment;
Automated Data Exchanges and Tape Matches
Updates sections for plain language and removes duplicate policy listed in other sections. (All Programs)
B-3000 TOC
Q TOC
Table of Contents (TOC) Updates TOC to add new sections and remove retired sections.
B-7440
B-8450
Alternate Care Services;
Special Reviews when Facility Contract Closure or Cancellation Occurs
Removes historical agency references and outdated information. (MEPD)
B-8400
B-9000 TOC
B-9100 (Reserve)
Procedures for Redetermining Eligibility;
Administrative Denials
Removes duplicative policy already listed in B-8400 and reserves section for future use. (All Programs)
C-2300 Custody of Records Updates contact information for reporting unauthorized inspection or disclosure of Internal Revenue Service (IRS) Federal Tax Information (FTI) or Social Security Administration (SSA) information. (All Programs)
C-2400 Safeguarding Federal Income Data Adds information about annual training and adds related policy. (All Programs)
C-2500 Disposal of Records Updates requirements for shredding documents. (All Programs)
D-5000 (TOC)
D-5220
D-8320
D-8610
Compact of Free Association States;
Qualified Aliens Not Subject to a Waiting Period or Limited Period;
Ineligible Aliens
Incorporates policy from MEPD and TW Bulletin 21-10, 1. Compact of Free Association (COFA) Citizens, released on May 20, 2021. (All Programs)
D-8000 TOC
D-8210
Terms Removes glossary terms and updates section title to “United States Citizenship and Immigration Services (USCIS) Documents.” (All Programs)
G-7000 Prior Coverage Clarifies policy and updates section for plain language. (All Programs)
G-7300 Emergency Coverage for Aliens Clarifies that the Form H3038, Emergency Medical Services Certification, must contain a handwritten signature from the medical practitioner. (MEPD)
H-2710 Using the TX Dental IME Fee Schedule Corrects the link to the Dental IME Fee Schedule. Updates the examples. (MEPD)
H-2720 Non-Allowable Deductions - Dental Adds additional non-allowable dental codes. (MEPD)
I-5100 Transfer of Assets Divisor Incorporates policy from MEPD and TW Bulletin 21-12, 3. Transfer of Assets Divisor, released on July 1, 2021. (MEPD)
J-7200
J-7400
Spousal Co-Payment;
Spousal Impoverishment Dependent Allowance
Incorporates policy from MEPD and TW Bulletin 21-11, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2021. (MEPD)
N-1320
O-1800
MBIC and Home and Community-Based Services Waivers;
Texas Home Living (TxHmL)
Revises that TxHmL waiver services are now paid under MBIC. (MBIC)
O-1000 Waiver Programs Updates sections for plain language. Adds related policy. (MEPD)
R-4300 Income and Eligibility Verification System Adds that IEVS includes information on unemployment insurance benefits (UIB) and removes historical information. Adds related policy. (All Programs)
R-4600 Public Assistance Reporting Information System (PARIS) Clarifies the process for PARIS Interstate matches and removes outdated information. (All Programs)
Glossary A, C, D, F, G, I, L, N, P, R, S, T, U Adds terms removed from D-8210. Updates terms for plain language. (All Programs)
Appendix XXXI
Appendix L
Budget Reference Chart;
2021 Income and Resources Reference Chart
Incorporates policy from MEPD and TW Bulletin 21-11, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2021, and MEPD and TW Bulletin 21-12, 3. Transfer of Assets Divisor, released on July 1, 2021. (MEPD)

Forms

The following forms were revised in the MEPD Handbook:

Form Title Change
Form H3038 Instructions Emergency Medical Services Certification Adds instructions clarifying that a “handwritten” signature from the medical practitioner signing the form is required. Removes electronic signature functionality from form.

Retired Bulletins

The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:

Release Date Bulletin Number Title
06-01-21 21-11 1. COVID-19 Update: Additional Emergency Allotment Supplement 2. Spousal Impoverishment Dependent Allowance
11-02-20 20-26 COVID-19 Policy Updates #18
09-21-20 20-23 COVID-19 Policy Updates #16
09-01-20 20-20 COVID-19 Policy Updates #14
07-29-20 20-18 COVID-19 Policy Updates #12
07-02-20 20-17 COVID-19 Policy Updates #11
05-20-20 20-14 COVID-19 Policy Updates #9
04-08-20 20-07 COVID-19 Policy Updates #4
05-14-15 15-06 Nursing Facility Medicaid to Managed Care and Incurred Medical Expense Changes
03-31-14 14-06 Social Security Administration - Security Awareness
07-12-13 13-09  Vietnamese Interpreter and Translation Information Page
07-03-13 13-08 Data Broker and Alien Status Verification Enhancement
05-06-08 08-11 Afghan and Iraqi Aliens with Special Immigrant Status
04-28-08 08-09 Applications and Restitution for State Schools Cases
01-15-08 08-03 Data Broker and Redeterminations for Medicaid for the Elderly and People with Disabilities
08-13-07 07-12 1. Incurred Medical Expense
2. DME Fee Schedule
3. ADA Survey of Fees

21-2, June Quarterly Revision

Revision Notice 21-2; Effective June 1, 2021

 

Archived Revision 21-1; Effective March 1, 2021
Archived Revision 20-4; Effective December 1, 2020
Archived Revision 20-3; Effective September 1, 2020
Archived Revision 20-2; Effective June 1, 2020

Revisions

The following sections were revised in the Medicaid for the Elderly and Persons with Disabilities (MEPD) Handbook:

Sections Section Title Change
E-6000
M-7000
Q-2000
Q-6000
Self-Employment Income;
Premiums;
Qualified Medicare Beneficiaries (QMB) – MC – QMB;
Qualified Disabled and Working Individuals (QDWI) –MC-QDWI
Updates sections for plain language. (All Programs)
E-6210 Self-Employment Expenses Incorporates policy from MEPD and TW Bulletin 21-03, 2. Mileage Rate Decrease, released on Feb. 5, 2021. Adds note regarding using the mileage rate instead of tracking actual transportation expenses. (All Programs)
M-5200
M-7100
N-6330
N-6351
Q-2500
Q-3200
Q-5200
Q-6200
Appendix IX
Appendix XXII
Appendix XXIX
Appendix XXXI
Appendix XXXIX
Appendix L
Medicaid Buy-In (MBI) Income Limits;
Post Eligibility – Premium Budgets;
Ineligible Sibling Exclusion;
Examples of Budgeting Steps;
QMB Income Limits;
SLMB Income Limits;
QI Income Limit;
QDWI Income Limit;
Medicare Savings Program Information;
Home and Community-Based Services Waiver Program Co-Payment Worksheets;
Special Deeming Eligibility Test for Spouse to Spouse;
Budget Reference Chart;
MBI Screening Tool and Worksheets;
2020 Income/Resources Reference Chart
Incorporates policy from MEPD and TW Bulletin 21-03, 4. 2021 Federal Poverty Level, released on Feb. 5, 2021. Updates sections and charts with 2021 FPL income and resource amounts. (All Programs)
Q-3000
Q-5000
Specified Low-Income Medicare Beneficiaries (SLMB) – MC-SLMB;
Qualifying Individuals (QIs)
Aligns language regarding dual eligibility for SLMB and QI for certain Medicaid recipients. (MSP)

Retired Bulletins

The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:

Release Date Bulletin Number Title
02-05-2021 21-03 1. COVID-19: Additional Emergency Allotment Supplement
2. Mileage Rate Decrease
3. Temporary Census Income
4. 2021 Federal Poverty Level
12-04-2020 20-29 Federal Benefits 2021 Cost-of-Living Adjustment (COLA)
11-30-2020 20-27 Electronic Benefit Transfer (EBT) Form Updates
10-22-2020 20-25 Retest Medicaid Eligibility for Persons Certified on Children’s Health Insurance Program (CHIP) or CHIP Perinatal (CHIP-P)
09-11-2020 20-22

1. TIERS Updates Related to Pre-Tax Contributions
2. MAGI Updates for Alimony
3. MAGI Updates for Moving Expenses
4. Determining Good Cause for SNAP Employment and Training Noncompliance
5. Revised SNAP Income Limits, Deductions, and Allotments
6. Revised TANF Maximum Grant Amounts
7. Revised SNAP-CAP Allotment

Attachment – SNAP Allotment Chart

05-12-2020 20-12 SNAP Online Purchasing Project
06-04-2020 20-11

1. Adult Certified for the Healthy Texas Women Program Leaves the Household
2. Alignment of Medicaid Certification Periods for all Children Living in the Same Household
3. Revised - New SNAP Benefits Distribution Schedule

03-02-2020 20-03 1. Activity Fees as an Allowable Dependent Care Deduction
2. Action on Prisoner Matches
3. Excluding the Full Value of Prepaid Burial Insurance
02-18-2020 20-02 Reasonable Opportunity for Healthy Texas Women (HTW)
10-21-2019 19-09 1. Alimony Paid for MAGI Expenses
2. Data Broker - Predictive Analytics Phase II

21-1, March Quarterly Revision

Revision Notice 21-1; March 1, 2021

 

Archived Revision 20-4; Effective December 1, 2020
Archived Revision 20-3; Effective September 1, 2020
Archived Revision 20-2; Effective June 1, 2020
Archived Revision 20-1; Effective March 1, 2020

 

Revisions

The following sections were revised in the Medicaid for the Elderly and Persons with Disabilities (MEPD) Handbook:

Sections Section Title Change
B-3300 Authorized Representative Updates Authorized Representative policy with information from MEPD Bulletin #15-05, 1. Updates to Authorized Representatives, released on April 3, 2015, and MEPD and Texas Works Bulletin #18-08, 3. Authorized Representative Correspondence, released on Sept. 6, 2018. (All Programs)
B-8400 Procedures for Redetermining Eligibility Adds information about administrative renewals from B-9100. (All Programs)
D-9410
G-1310
G-1320
G-2311.2
G-2312.1
H-6000
J-7200
J-7300
M-7100
Appendix IX
Appendix XII
Appendix XXII
Appendix XXIX
Appendix XXXI
Appendix XXXIII
Appendix XXXVI
Appendix XXXVIII
Appendix L
Appendix LIII
Examples of Sponsor-to-Alien Income Deeming; Community-Based Programs Using SSI Limits; Special Income Limits; Examples of Spouse-to-Spouse Deeming; Examples of Parent-to-Child Deeming; Co-Payment for SSI Cases; Spousal Co-Payment; ICF/IID Spousal Companion Cases; Post Eligibility — Premium Budgets; Medicare Savings Program Information; Nursing Facility and Home and Community-Based Services Waiver Information; Home and Community-Based Services Waiver Program Co-Payment Worksheets; Special Deeming Eligibility Test for Spouse to Spouse; Budget Reference Chart; Medicaid for the Elderly and People with Disabilities Information; Qualified Income Trusts (QITs) and Medicaid for the Elderly and People with Disabilities (MEPD) Information; Pickle Disregard Computation Worksheet; 2021 Income/Resources Reference Chart; Sponsor to Alien Deeming Worksheet Updates sections and charts based on the 2021 Cost of Living Adjustment (COLA) from MEPD and Texas Works Bulletin #20-29, Federal Benefits 2021 Cost-of-Living Adjustment (COLA), released Dec. 4, 2020. (All Programs)
F-3600
F-3610
Substantial Home Equity; Persons Impacted by Substantial Home Equity Disqualification Updates substantial home equity limits for 2021 from MEPD and Texas Works Bulletin #20-29, Federal Benefits 2021 Cost-of-Living Adjustment (COLA), released Dec. 4, 2020. (MEPD)
G-4310 Computing Social Security Cost-of-Living Increases Updates reference chart with the new Pickle multiplier from MEPD and Texas Works Bulletin #20-29, Federal Benefits 2021 Cost-of-Living Adjustment (COLA), released Dec. 4, 2020. (MEPD)
H-1800 Medicare Part B Premium Updates the standard Medicare Part B premium for 2021 from MEPD and Texas Works Bulletin #20-29, Federal Benefits 2021 Cost-of-Living Adjustment (COLA), released Dec. 4, 2020. (All Programs)
M-8500 Denial Reasons Adds information about the notice staff use when denying Medicaid Buy-In (MBI). (MBI)
M-9000 Notices and Forms Adds information about the notice staff use when denying MBI. (MBI)
Q-1300 MSP Resource Limits Updates resource limits for 2021 multiplier from MEPD and Texas Works Bulletin #20-29, Federal Benefits 2021 Cost-of-Living Adjustment (COLA), released Dec. 4, 2020. (MSP)
Glossary Glossary Part A Modifies the definition of Authorized Representative. (All Programs).
Appendix VI SSA Claim Number Suffixes Updates SSA Claim Number Suffixes. (All Programs)

 

Forms

The following forms were revised in the MEPD Handbook:

Form Title Change
Form H1861 and Instructions Federal Tax Information Record Keeping and Destruction Log Updates form to comply with federal IRS policy.
Form H1862 and Instructions Federal Tax Information Transmittal Memorandum Removes obsolete reference to Budget Job Number.

 

Retired Bulletins

The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:

Release Date Bulletin Number Title
06-11-20 20-16 Spousal Impoverishment Dependent Allowance
02-05-20 20-01
  1. 2020 Federal Poverty Level
  2. Incurred Medical Expenses (IME) Forms Automation
  3. Mileage Rate Decrease
09-06-18 18-8
  1. Modified Adjusted Gross Income (MAGI) Household Composition and Household Income Exception Updates for Tax Dependents Age 19 and Older
  2. Healthy Texas Women Auto-Enrollment Expansion
  3. Authorized Representative Correspondence
  4. Medicaid for the Elderly and People with Disabilities (MEPD) and Medicare Savings Program (MSP) Review Changes
06-13-18 18-5
  1. Verifying Fleeing Felons and Parole/Probation Violators for SNAP and TANF
  2. Able Bodied Adult Without Dependents (ABAWD) Streamlined Reporting (SR) Requirements
  3. Applicant’s Right to Copies of Submitted Applications
  4. Lawfully Residing Status Codes for Children’s Medicaid and Children’s Health Insurance Program (CHIP)
  5. 2018 Spousal Dependent Allowance 6. Updates to Medicaid After Supplemental Security Income Denial - Children and Qualified Medicare Beneficiary
04-03-15 15-5
  1. Updates to Authorized Representatives 2. Electronic Correspondence 3. Preferred Languages for Correspondence

20-4, December Quarterly Revision

Revision Notice 20-4; December 1, 2020

 

Archived Revision 20-3; Effective September 1, 2020
Archived Revision 20-2; Effective June 1, 2020
Archived Revision 20-1; Effective March 1, 2020
Archived Revision 19-4; Effective December 1, 2019

 

Revisions

The following sections were revised in the Medicaid for the Elderly and Persons with Disabilities (MEPD) Handbook:

 

Sections Section Title Change
A-4200 Program of All-Inclusive Care for the Elderly (PACE) Corrects information on Medical Necessity (MN). (MEPD)
B-5000 Previously Completed Application Adds information on failure to provide verification of Level of Care (LOC) or MN. (MEPD)
B-6510 Failure to Provide Missing Information Adds clarification that the date on the H1020, Request for Information or Action, is the date an application could be denied if verification is not received. (All Programs)
B-7420
D-7400
I-3100
Level of Care/Medical Necessity; Use of Third-Party Resources; Transfer of Home Removes historical agency references. Adds clarifying language. (All Programs)
B-7430 Effect of Utilization Review on Eligibility Reserves for future use. (All Programs)
B-7450 Medicaid Certified Person Enters Nursing Facility or Home and Community-Based Services Waiver Program Removes historical agency reference. Replaces the reference to Appendix XI with a reference to R-1300. (All Programs)
G-2311.2 Examples of Spouse-to-Spouse Deeming Updates examples with 2020 MSP income limits and deeming amounts. (MSP)
H-2900 IME Notices Replaces reference to Appendix XI with a reference to R-1300. (MEPD)
J-7200 Spousal Co-Payment Updates with 2020 Spousal Impoverishment Dependent Allowance and corrects budget example. (MEPD)
O-2100 Program for All-Inclusive Care for the Elderly (PACE) Corrects information on MN. (MEPD)
Q-1200 Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) Removes historical language and outdated processing information. Updates link to the MIPPA job aid. (MSP)
TOC
B-7000
Special Application Procedures Reserves B-7430 for future use. (All Programs)
Glossary G Adds definition for Good Cause.

 

Retired Bulletins

The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:

Release Date Bulletin Number Title
09-10-19 19-8
  1. Revised SNAP Income, Limits, Deductions, and Allotments
  2. Revised TANF Maximum Grant Amounts
  3. Public Benefit Integrity Unit Messages in Data Broker
  4. Quality Control Sanctions in Data Broker