| Rule Number: |
24P033 |
| Title: |
Health Benefits Eligibility and Enrollment Rule, Eligibility-and-Enrollment Procedures (Part 7). |
|
Type:
|
Standard |
|
Status:
|
Adopted |
| Agency: |
Agency of Human Services
|
| Legal Authority: |
3 V.S.A. 801(b)(11); 33 V.S.A. 1901(a)(1) and 1810 |
| Summary:
| This proposed rulemaking amends Parts 2, 3, and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 2, 3, and 7 were last amended effective January 1, 2024. Substantive revisions include: making beneficiary-friendly changes to Transitional Medical Assistance eligibility; codifying the exclusion of dividend/interest income for purposes of Medicare Savings Program eligibility; repealing the exception of Deferred Action for Childhood Arrivals
(DACA) recipients as being "lawfully present" for purposes of Qualified Health Plan eligibility; repealing the requirement to pursue potential unearned income for purposes of Medicaid eligibility; codifying the automatic enrollment of SSI recipients as Qualified Medicare Beneficiaries; codifying the 90-day post-denial reconsideration period for Medicaid applicants who did not cooperate with the application process; and repealing the interview requirement for purposes of long-term care Medicaid eligibility. |
| Persons Affected:
| Medicaid applicants/enrollees; Individuals who wish to purchase health coverage including those who apply for premium and cost-sharing assistance; Health insurance issuers;
Eligibility and enrollment assisters, including agents and brokers; Health care providers; Health law, policy and related advocacy and community-based organizations and groups including the Office of the Health Care Advocate; and Agency of Human Services including its departments. |
| Economic Impact:
| The substantive revisions in this rulemaking are anticipated to be budget neutral to the State. The Medicaid budget has had the impact of many of these changes embedded for years due to the Medicaid continuous coverage requirements in place during the COVID-19 Public Health Emergency and temporary flexibilities that Vermont has utilized during the unwinding of the continuous coverage requirements. Other changes in Parts 2, 3, and 7 align the rule with federal and state guidance and law, provide clarification, correct information, improve clarity, and make technical corrections. These changes do not carry a specific economic impact on any person or entity. |
| Posting date: |
Sep 04,2024 |
