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

Groups Covered Under Medicaid 510-05-30-05
This section is updated to reflect a new effective date.

2.	The optional categorically needy group includes:

f.	Children with Disabilities under age 19 (including the month attaining age 19) who meet medically needy nonfinancial criteria, have income at or below 200% of the poverty level, and are not eligible for full Medicaid benefits under any other provision. Effective March April 2008.

State Residence 510-05-35-85
This section is updated to report South Dakota’s withdrawal from the reciprocal residency agreement.

8.	If an interstate reciprocal residency agreement has been entered into between this state and another state pursuant to 42 CFR 435.403(k), the state of residence of an affected individual is the state determined under that agreement.

North Dakota has an interstate reciprocal residence agreement with ten nine states. The agreement provides that individuals of any age institutionalized in one of these states are considered a resident of the state in which they are institutionalized.  

	The states with whom we have the agreement are:
	California	South Dakota	Tennessee
	Florida	New Mexico	Texas
	Kentucky	Ohio	Wisconsin
	Pennsylvania

General Information 510-05-58-05
This section is updated to reflect a new effective date.

The Children with Disabilities coverage allows options to families of children with disabilities under age 19, who are not eligible for Medicaid or who are eligible for Medicaid and have a recipient liability, to buy into Medicaid. This coverage became effective in North Dakota on March April 1, 2008.

Income Levels 510-05-85-40
This section is updated with the new family member income level for spousal impoverishment cases and the new poverty related income levels. 

2.	Medically needy income levels.
d.	Family member income level. The income level for each ineligible family member in a spousal impoverishment case is $571584 effective April 20078 ($550571 effective April 20067).
3.	Poverty income levels.
a.	Qualified Medicare Beneficiaries 

Number of Persons	Monthly Income Level	
1	 $ 851867	
2	   11411167	
3	   14311467	
4	   17211767	
5	   20112067	
6	   23012367	
7	   25912667	
8	   28812967	
Effective April 1, 20078	
For each person in the Medicaid unit above eight, add $290300 to the monthly amount.

b.	Specified Low-Income Medicare Beneficiaries 
Number of Persons	Monthly Income Level	
1	 $10211040	
2	   13691400	
3	   17171760	
4	   20652120	
5	   24132480	
6	   27612840	
7	   31093200	
8	   34573560	
Effective April 1, 20078	
For each person in the Medicaid unit above eight, add $348360 to the monthly amount.

c.	Pregnant women and children under age six. 
Number of Persons	Monthly Income Level	
1	 $11321153	
2	 15181552	
3	 19031951	
4	 22892350	
5	 26752749	
6	 30613148	
7	 34463547	
8	 38323946	
Effective April 1, 20078	
 
For each person in the Medicaid unit above eight, add $386399 to the monthly amount.

d.	Qualifying Individuals. 
Number of Persons	Monthly Income Level	
1	 $ 11491170	
2	   15411575	
3	   19321980	
4	   23242385	
5	   27152790	
6	   31073195	
7	   34983600	
8	   38904005	
Effective April 1, 20078	
For each person in the Medicaid unit above eight, add $392405 to the monthly amount.
e.	
Transitional Medicaid Benefits. 
Number of Persons	Monthly Income Level	
1	 $15751603	
2	   21112158	
3	   26482713	
4	   31843268	
5	   37213823	
6	   42574378	
7	   47944933	
8	   53305488	
Effective April 1, 20078	
For each person in the Medicaid unit above eight, add $537555 to the monthly amount.
f.	
Workers with Disabilities.  
Number of Persons	Monthly Income Level	
1	 $19141950	
2	   25662625	
3	   32193300	
4	   38713975	
5	   45244650	
6	   51765325	
7	   58296000	
8	   64816675	
Effective April 1, 20078	
For each person in the Medicaid unit above eight, add $652675 to the monthly amount.
g.	
Children with Disabilities. 
Number of Persons	Monthly Income Level	
1	 $17021733	
2	   22822333	
3	   28622933	
4	   34423533	
5	   40224133	
6	   46024733	
7	   51825333	
8	   57625933	
Effective MarchApril 1, 2008	
For each person in the Medicaid unit above eight, add $580600 to the monthly amount.

Par. 2.   Effective Date – This manual letter is effective for the benefit month of April 2008.