Par. 1.  Material Transmitted and Purpose --Transmitted with this Manual Letter are changes to Service Chapter 510-05, Medicaid Eligibility Factors:

05-10-10.   Nondiscrimination in Federally Assisted Programs

A correction was made to remove language from the last paragraph because it duplicated language already in the previous paragraph.  
The Medicaid Program will be administered in accordance with all provisions of Title VI of the Civil Rights Act in accordance with Section 504 of the Rehabilitation Act of 1973, as amended, and the applicable regulations promulgated thereunder. Refer to Service Chapter 300-01, Non-discrimination to Clients, for additional guidelines.

	05-25-20.    Medicaid Brochures

The requirement to provide the “Notice of Privacy Practices” was added to subsection 1.  The appendix references for the other brochures in this section were replaced with the appropriate section reference.
1.	All applicants for Medicaid must be provided:
a.	A brochure entitled “Medicaid” (Appendix C 05-100-15) outlining the services available under the Medicaid Program; and 
b.	A brochure entitled “Your Civil Rights” (Appendix D 05-100-20); and
c.	A notice entitled “Notice of Privacy Practices” (DN 900 which is available in E-Forms).
2.	All households with individuals of childbearing age must be made aware of the opportunity they have to receive family planning services and must be given a brochure entitled "Family Planning-Choosing Your Family Size," or "Family Planning Program" (Appendix E 05-100-25).
3.	All households with individuals under the age of twenty-one must be made aware of the availability of "North Dakota Health Tracks" (early and periodic screening, diagnosis and treatment services) and be given the brochure entitled "ND Health Tracks" (Appendix F 05-100-30).
4.	All households with pregnant, breast feeding or postpartum women, or children under age five, must be made aware of the availability of the WIC (Women, Infants, and Children) Program, and must be provided a "WIC" outreach brochure (Appendix G 05-100-35).
5.	Acknowledgment that the applicant received such information is contained on the application form.

05-25-30.   Appeals
A correction was made to correct the Chapter 449 reference in subsection 6.  
6.	Refer to Service Chapter 449-0840 for more information with regard to Hearings and Appeals.

05-35-80.  Social Security Numbers 

Language was changed in subsection 2 as Chapter 449 no longer provides instructions on assisting individuals to apply for a social security number.  
2.	Persons who do not have a number may be assisted by must be referred to the Social Security Administration to apply for one.  The county agency in obtaining one as provided in Service Chapter 449-04. may assist the applicant as needed.

05-45-35.  Income Disregards and Deductions for the Family Coverage Group

Subdivision c in subsection 3 was removed because it repeated language from subdivision b.
c. 	When the case includes a stepparent who is not eligible, or when a caretaker who is under age 18 lives at home with both parents and the parents are not eligible under the Family Coverage group, a deduction is allowed for amounts actually being paid by the stepparent or parents to any other persons not living in the home who are, or could be, claimed by the stepparent or parents as dependents for federal income tax purposes.

05-60-20.  Asset limits for the Medicare Savings Program
A correction was made to the administrative rule cite.

05-80-05.  Disqualifying Transfers 
The 2005 average cost of nursing care is added to the manual.  This supercedes IM 4958.
10.	The average cost of nursing facility care is:
 
Year	Daily Rate	Monthly Rate	
2005	144.48	4395	

05-85-30.  Disregarded Income 

Additional military pay received for service in a combat zone is added to the list of disregarded income.  This supercedes IM 4961.

41.	The first $2,000 per year of lease payments deposited in IIM accounts; and
42.	Interest or dividend income from assets.; and
43.	Additional pay received by military personnel as a result of deployment to a combat zone.

05-85-40.   Income Levels

The poverty levels are updated effective April 1, 2005, as well as the spousal impoverishment family member income level (increases to $534).  The income level tables were shortened in size from ten to eight.

05-90-15.  Guidelines for Anticipating Income

A correction was made to the second paragraph.  The guidelines apply to all individuals and not just applicants.

An employed applicant individual who does not expect a significant change in income should have the previous month's earnings verified by pay stub or employer's statement. The previous month’s earnings serve as the basis for estimating the income likely to be received during the initial prospective month. To illustrate, a person applies for assistance on November 15 and reports there should be no significant change in income from the month of October. The October income should be verified to anticipate the income likely to be available in November.

05-95-30.  Primary Care Provider Program

The Primary Care Program applies to children up to age 21.  A correction has been made to reflect this.

The department has elected mandatory enrollment of eligible caretaker relatives, poverty level pregnant women, and children 18 21 years of age and under, into managed care. The purpose of this mandatory enrollment is to assure adequate access to primary care, improve the quality of care, promote coordination and continuity of health care, reduce costs, and to assist recipients to use the health care system appropriately. The Primary Care Provider Program also establishes co-payments for certain services. Information about the program can be found in Service Chapter 510-06.

Par. 2.  Effective Date  -- April 2005