SR 02-19 Dated 07/02

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases:

·   revisions to Form 800P, Application for NH Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women, and its instructions;

·   new Form 800PR, Review For Continued Eligibility For NH Healthy Kids Medical Insurance and Medical Coverage for Pregnant Women, and its instructions; and

·   a revision to the treatment of Medicare coverage when determining eligibility for Healthy Kids medical coverage programs. Medicare coverage is no longer considered health insurance when assessing prior or current insurance coverage during eligibility determinations for Healthy Kids funded under Title XXI, SCHIP.

In addition, as a result of the release of new Form 800PR, Form 800CP, Annual Eligibility Review for New Hampshire Healthy Kids Medical Insurance, and its instructions, have been obsoleted.

POLICY

Revisions to Form 800P, Application for NH Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women, and the creation of new Form 800PR, Review For Continued Eligibility For NH Healthy Kids Medical Insurance and Medical Coverage for Pregnant Women, are a continuation of the Department’s effort to eliminate enrollment barriers in the NH Healthy Kids Programs. In addition, the forms incorporate the verification policy changes in the Healthy Kids-Silver (HKS) and Children Up to Age 19 Programs (HKG-300, HKG-185, HKG-CH) released by SR 02-03, dated April 2002.

New Form 800PR will now be provided to all current recipients of Healthy Kids or Medical Coverage for Pregnant Women (MCPW) eligible for the DFA mail-in redetermination process. Form 800PR replaces Form 800CP, Annual Eligibility Review for New Hampshire Healthy Kids Medical Insurance, the explanatory cover letter that previously accompanied the Form 800P during the HK and MCPW redetermination process. See the FORMS REVISIONS section below for additional revisions to Form 800P and Form 800PR.

In addition, federal guidance from the Centers for Medicare and Medicaid Services (CMS) has clarified that Medicare coverage is no longer considered health insurance when assessing prior or current insurance coverage during eligibility determinations for the Healthy Kids medical coverage programs. This policy change will affect children applying for HKS and HKG-300 who are currently receiving Medicare or have received Medicare in the 6 months prior to application due to certain disabilities or permanent kidney failure.

FORMS REVISIONS

Form 800P, Application for NH Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women, was greatly revised to improve clarity and reduce barriers in enrollment by providing applicants with:

·   less complicated language in all areas of the application, from the explanation of the programs to the description of the types of proof needed and why;

·   two greatly revised introductory pages to the application, a "Cover Letter" page and a "Checklist of Required Proof" page, which makes it easier for applicants to understand the enrollment process and to provide the required verification needed to facilitate the eligibility determination process; and

·   the updated verification requirements as released by SR 02-03, dated April 2002.

New Form 800PR, Review For Continued Eligibility For NH Healthy Kids Medical Insurance and Medical Coverage for Pregnant Women, will now be used for all mail-in redeterminations. This form was created to reduce re-enrollment barriers for recipients eligible for the mail-in process, and replaces Form 800CP, the explanatory cover letter that previously accompanied the Form 800P during the HK and MCPW redetermination process. Because this new form was created to be used only for HK or MCPW redeterminations, many of the requirements specific to applicants were removed, making it simpler for current recipients to complete the re-enrollment process. In addition, the new form provides:

·   two introductory pages, a "Cover Letter" page and a "Checklist of Required Proof" page, which describes the redetermination process and furnishes recipients with a physical check-off list for all the verification needed to redetermine eligibility;

·   information about how to add another child to Healthy Kids; and

·   the updated verification requirements as released by SR 02-03, dated April 2002.

Similar to the revisions made to Form 800P, Form 800PR uses less complicated language throughout the form to improve clarity and ease the redetermination process for the recipient.

NEW HEIGHTS PROCEDURES

Because New HEIGHTS is not programmed to allow eligibility for HKS or HKG-300 when the child has concurrent health insurance coverage, District Office staff must contact the Help Desk for assistance with applicants who are also covered by Medicare. Healthy Kids applicants with concurrent Medicare coverage are expected to be few.

District Offices will be notified when New HEIGHTS programming to allow concurrent Medicare coverage is complete.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 161.01  Timely Notice

Section 161.05  Processing Redeterminations/Recertifications

Section 161.07  Termination at Redetermination/Recertification

Section 220.03  Eligibility Requirements

IMPLEMENTATION

Forms

The current versions of the application and mail-in redetermination forms released by SR 99-26 dated 5/99, remain valid and any application or reapplication submitted on the old versions must be treated accordingly. However begin using the revised Form 800P and the new Form 800PR upon receipt.

A certificate of destruction has been included in this SR for the Form 800CP, obsoleted with the release of new Form 800PR, and the current version of Form 800P. As mentioned above, these forms remain valid applications and current stock is not to be destroyed or recycled until the new versions of Forms 800P and 800PR have been received.

Treatment of Medicare Coverage in the Healthy Kids Program

The policy change revising the treatment of Medicare coverage when determining eligibility for Healthy Kids medical coverage will be implemented statewide beginning July 1, 2002 for current cases, and will apply to any new cases processed on or after that date.

CLIENT NOTIFICATION

No special notification is necessary. District Offices, providers, and clients will begin to use the new forms upon receipt and the revised treatment of Medicare coverage will be applied when HKG-300 or Healthy Kids-Silver medical coverage group benefits are requested.

TRAINING

No special training is necessary.

POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.state.nh.us/PMIndex.htm, effective August 1, 2002.

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Family Assistance and Forms Manual.

DFA/JBV:s