The proposed rule amends the requirement to verify a loss or reduction of income which occurred within the 60 days preceding an application date to the requirement to verify a loss or reduction of income which occurred within the month of ...

 

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency Program

RULE NO.: RULE TITLE:
65A-1.707: Family-Related Medicaid Income and Resource Criteria

PURPOSE AND EFFECT: The proposed rule amends the requirement to verify a loss or reduction of income which occurred within the 60 days preceding an application date to the requirement to verify a loss or reduction of income which occurred within the month of application. Included in this proposed rule amendment are some wording changes improving the overall content of the rule and technical changes of a non-substantive nature.

SUMMARY: The proposed rule amends when loss or reduction of income must be verified.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: The Department considered the factors in Section 120.541, F.S. The proposed rule is not expected to exceed the criteria in paragraph 120.541(2)(a), F.S., therefore, legislative ratification is not required under subsection 120.541(3), F.S.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.903, 409.919 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: May 4, 2012, 1:30 p.m.

PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, Florida 32399-0700

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 7 days before the workshop/meeting by contacting: Cindy Keil. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Cindy Keil, Economic Self-Sufficiency Program, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700, [e-mail], [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

65A-1.707 Family-Related Medicaid Income and Resource Criteria.

(1) Family-related Medicaid income is based on the definitions of income, resources (assets), verification and documentation requirements as follows.

(a) through (d) No change.

(e) Verification and Documentation.

1. Except for Transitional Medicaid, and when reporting changes in income at times other than the twelve month complete Medicaid review, income must be verified or documented by the employer as a condition of eligibility for family-related Medicaid. Note that separate verification and documentation requirements for KidCare are stated in subsection 65A-1.705(8) 65A-1.705(5), F.A.C. Income will be verified through a telephone call to the employer or source of income or by documents such as wage stubs or correspondence signed by the employer or employer’s authorized representative. Income from self employment must be verified. The applicant or recipient must make all business records available to the eligibility specialist upon request.

2. A loss or reduction of income which occurred within the month of 60 days preceding an application date and the cause of the reduction or loss must be verified. Availability of replacement income will be discussed with the applicant or recipient. The applicant or recipient must provide the date of expected return to work when on leave, vacation, or furlough.

3. No change.

(f) Money Management. Money management is the comparison of the income received and major expenses paid by the applicant or recipient. When currently paid expenses exceed acknowledged income, possible sources of other income must be determined and verification or documentation of that income must be obtained.

1. An applicant or recipient shall be required to explain money management during the month of application or redetermination. Eligibility shall not be determined if an individual fails to do so. However, a case shall not be denied or canceled solely because of a person’s failure to explain how bills are paid. In the instance of failure to explain how bills are paid, the eligibility specialist shall request the applicant or recipient to furnish additional information. Failure by the applicant or recipient to provide the additional information during the time requested will result in the denial of the case because eligibility cannot be determined, except when the family is eligible for transitional Medicaid.

2. An applicant or recipient shall also be required to explain money management for the month prior to or after the month of application or redetermination when the paid expenses for that month exceed the income for that month. However, a case shall not be denied or canceled solely because of a person’s failure to explain how bills are paid in the month prior to or after the month of application. In the instance of failure to explain how bills are paid for months prior to or after the month of application, the eligibility specialist shall request the applicant or recipient to furnish additional information. Failure by the applicant or recipient to provide the additional information during the time requested will result in the denial of the case because eligibility cannot be determined, except when the family is eligible for transitional Medicaid.

(2) No change.

Rulemaking Authority 409.919 FS. Law Implemented 409.903, 409.919 FS. History–New 10-8-97, Amended 2-15-01, 11-23-04, 2-20-07, 5-6-08,________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jeri Flora

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: David E. Wilkins

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: March 21, 2012

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: January 27, 2012