SR 02-42 Dated 08/02

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

OÁ*This SR eliminates the estate recovery requirement for medical assistance received though the Qualified Medicare Beneficiary (QMB) Program, the Specified Low-Income Medicare Beneficiary (SLMB) Programs (SLMB120, SLMB135, or SLMB175), or the Qualified Disabled Working Individuals (QDWI). The revised policy applies only to QMB/SLMB/QDWI related services and does not change the recovery policy for financial assistance or other Medicaid programs.

POLICY

The estate recovery requirement has been eliminated for recipients of QMB/SLMB/QDWI services. As a result, the Office of Finance will no longer pursue estate recovery for recipients of QMB/SLMB/QDWI services. District Offices are no longer required to provide QMB/SLMB/QDWI applicants with Form 770, Reimbursement Agreement and Acknowledgment, or complete the Estate Referral Screen on New HEIGHTS for these individuals, unless the individual is requesting full Medicaid eligibility.

QMB/SLMB/QDWI clients complete Form 800Q, Assisted Application for Help with Medicare Costs for Medicare Beneficiaries, to apply for assistance with their Medicare costs. This form is a 2-page, double-sided mail-in application used by New Hampshire Housing Authority (NHHA) residents. Other applicants may use Form 800Q to apply for these programs when assisted by a volunteer from the Health Insurance Counseling, Education, and Assistance Services (HICEAS) program.

Form 800Q will be revised in the future to delete references to the estate recovery requirement which appears on page 4. In the interim, NHHA staff and HICEAS volunteers have been advised to:

·   notify applicants that the estate recovery requirement no longer applies; and

·   cross out the following statement which appears on page 4:

"I understand that anyone age 55 or older who receives medical assistance from the Department, including help with Medicare costs, is required by State Law RSA 167:14-a to reimburse the State for the costs of all medical assistance received. I also understand that no reimbursement claim will be filed until I, and my spouse, are deceased."

If an applicant applies directly to the District Office using Form 800Q, the District Office must cross out the above reimbursement statement and advise the client that the estate recovery requirement no longer applies.

Revised Adult Assistance Manual Topics

PART 317 REIMBURSEMENT

Section 317.03 Reimbursement - Medical Assistance for Non-Institutionalized Individuals

IMPLEMENTATION

The revised policy is retroactive to August 13, 2002.

CLIENT/PROVIDER NOTIFICATION

NHHA staff and HICEAS volunteers have been notified of the revised policy as indicated in the text of this SR. Clients will be notified on an as needed basis.

TRAINING

There will be no training due to the procedural nature of this SR.

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/DHHS/DFA/LIBRARY/Manual/A1.htm effective December 2, 2002.

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

DFA/SJC:s