MaineCare Rule #308P - Eligibility and Verification Changes

Date posted:

Attachment(s):

The Department proposes rule changes to the MaineCare Eligibility Manual, Part 2, Basic Eligibility Criteria consistent with the Centers for Medicaid and Medicare Services’ “2023 Streamlining Medicare Savings Program Enrollment” final rule (89 FR 22780). The proposed rule removes the requirement that applicants apply for other benefits as a condition of MaineCare eligibility. Additionally, it removes the limit on the number of reasonable opportunity periods for individuals verifying their citizenship and immigration status.

The proposed rule would make the following changes to Part 2:

  • Section 3.1, (III)(B) would remove “not” from “A reasonable opportunity period will not be provided on subsequent applications submitted by or on behalf of the applicant or household members.”
  • Section 3.4, (H) would capitalize Batterer(s).
  • Section 10, “APPLICATION FOR MEDICARE” would replace “APPLICATION FOR OTHER BENEFITS”
  • Section 10 would remove “Individuals must apply for other benefits to which they may be entitled.  This includes applying for the benefit and providing the Department with necessary information to determine eligibility.”
  • Section 10 would remove I. “Other benefits include but are not limited to, Social Security, Railroad Retirement, Veteran’s Pension/Compensation, Worker’s Compensation, and Unemployment Insurance. This provision does not apply to SSI, State Supplement, TANF cash benefits and other Federal, State, local or private programs which make payments based on need.”
  • Section 10 would remove V. “The Department will not require an individual:”
  • Section 10 would remove V.A. “To file for other benefits when applying for them would result in no additional benefits which affects the individual’s eligibility.”
  • Section 10 would V.B. “To pursue a claim for other program benefits through the appeals process.”
  • Section 10 would remove V.C. “Who is not applying for or covered by Medicaid to pursue a claim for other program benefits, for example, an ineligible spouse, parent or child.”

The proposed rule changes would be effective June 1, 2024. Retroactive rulemaking is permissible under 22 M.R.S. § 42(8) as these updates provide a benefit to recipients and applicants.

Office: Office for Family Independence

Comment deadline:

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