907 KAR 20:015. Medicaid right to apply and reapply for individuals whose Medicaid eligibility is not based on a modified adjusted gross income or who are not former foster care individuals.

 

      RELATES TO: KRS 205.520

      STATUTORY AUTHORITY: KRS 116.048, 194A.030(2), 194A.050(1), 205.502(3), 42 C.F.R. 435.906, 435.907, 435.909, 435.911, 435.912, 42 U.S.C. 1396a, b, d, 1973gg-10, EO 2004-726

      NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726, effective July 9, 2004, reorganized the Cabinet for Health Services and placed the Department for Medicaid Services and the Medicaid Program under the Cabinet for Health and Family Services. The Cabinet for Health and Family Services has responsibility to administer the Medicaid Program. KRS 205.520(3) empowers the cabinet, by administrative regulation, to comply with any requirement that may be imposed or opportunity presented by federal law for the provision of medical assistance to Kentucky's indigent citizenry. This administrative regulation sets forth provisions relating to the procedure by which an application for Medicaid coverage is filed. KRS 116.048 designates the cabinet to have responsibility for the administration of public assistance programs as a voter registration agency in accordance with 42 U.S.C. 1973gg-10. Therefore, this administrative regulation sets forth policy and procedure necessary to provide an eligible Medicaid recipient the opportunity to register, or to decline from registering, to vote.

 

      Section 1. Right to Apply or Reapply. (1) Each individual wishing to do so shall have the opportunity to apply or reapply for Medicaid through the Department for Social Insurance (DSI).

      (2) An individual eligible for Aid to Families with Dependent Children (AFDC), State Supplementation or Supplemental Security Income (SSI) through the Social Security Administration shall be eligible for Medicaid without a separate application.

      (3) An individual applying on the basis of age, blindness or disability shall not be eligible as a medically needy individual, under 907 KAR 1:011, if his income and resources are within SSI limits. Denial of assistance by the Social Security Administration for SSI for technical reasons shall also be considered a denial for Medicaid.

 

      Section 2. Application Process. (1) An application shall be considered to have been made when the individual or his representative has signed, under penalty of perjury, the application form prescribed by the DSI or the Social Security Administration, for SSI, and the application has been received at the appropriate office.

      (2) An application shall also be considered to be made based on the date of contact with DSI or the Social Security Administration for SSI, by a person with a physical or mental impairment who needs special accommodation due to his impairment.

      (3) If the applicant is unable to come to the office to apply, he may designate an authorized representative to apply for him or request a home visit to complete the application process.

      (4) The applicant may be assisted by an individual of his choice in the application process and may be accompanied by this individual in all contacts with the agency.

      (5) Deaf and hard of hearing services shall be provided in accordance with 900 KAR 1:070.

      (6) Interpreter services shall be provided for persons who do not speak English, utilizing procedures and forms specified by 900 KAR 1:070.

 

      Section 3. Who May Sign an Application. (1) An application for Medicaid shall be signed by the individual requesting assistance, the relative with whom the child lives, or an interested party acting on behalf of the applicant.

      (2) An application for Medicaid for children in foster care or private child caring institutions shall be signed by the representative of the agency to which the child is committed or the institution in which the child is placed.

 

      Section 4. Where Applications are Filed and Processed. (1) The application may be filed at any DSI office and shall be processed in the county of residence except that any application for SSI and Medicaid shall be filed in the service area office of the Social Security Administration.

      (2) If an individual is applying for nursing facility or psychiatric facility services, the DSI office in the county where the facility is located shall take and process the application.

      (3) If an individual is applying in a county other than the county of residence and is hospitalized, the DSI office in the county of hospitalization shall take the application and transfer the pending application to the county of residence, and the DSI office in the county of residence shall process the application using the original application date.

      (4) If an individual is applying in a county other than the county of residence and is not hospitalized, the DSI office in the receiving county shall partially complete the application, transfer the application to the county of residence on the same day the application is taken, and explain to the applicant that the application shall be processed in the county of residence. The DSI office in the county of residence shall schedule a face-to-face interview and process the application using the original application date.

      (5) If a Kentucky resident is temporarily out of state, a letter from the applicant, an interested party or an out-of-state agency shall be accepted as the initiation of the application process when an emergency arises from accident or sudden illness, care and services are needed immediately, and the individual's health would be endangered if he undertook to return to the state. Upon notification of the emergency, the official application form shall be forwarded to the initiating party.

 

      Section 5. Action on Applications. (1) A decision shall be made on each Medicaid application within forty-five (45) days, except that for applications requiring a disability determination, sixty (60) days shall be allowed.

      (2) Time frame exceptions:

      (a) If the applicant is cooperating but is unable to obtain necessary verification for an eligibility decision to be made; or

      (b) If the delay is beyond the control of staff (such as failure or delay on the part of the applicant or examining physician or because of some administrative or other emergency that could not be controlled by staff).

      (3) The case record shall document the cause for the time standard delay.

      (4) Failure to process an application within the above time frame shall not be used as the basis for denial.

 

      Section 6. Voter Registration. (1) An applicant or recipient meeting all of the following criteria shall be provided the opportunity at the local Department for Social Insurance office to complete an application to register to vote or update his current voter registration:

      (a) Be age eighteen (18) or over;

      (b) Be present in the office at the time of the interview or if a change of address is reported; and

      (c) Not be registered to vote or not registered to vote at his current address.

      (2) The following individuals shall not be permitted to register to vote by the process established in this administrative regulation:

      (a) An individual not included in the Medicaid application;

      (b) A Medicaid payee only;

      (c) An authorized representative of a Medicaid recipient; or

      (d) An individual acting as a responsible party.

      (3) An individual providing voter registration services who seeks to unlawfully influence an applicant's political preference or party registration as prohibited by KRS 116.048(4) could be fined or imprisoned, not to exceed five (5) years, or both.

      (4) Forms and information utilized in the voter registration process shall remain confidential and used only for voter registration purposes.

      (5) Only Board of Elections officials may view forms and information utilized directly in the voter registration process.

      (6) Completion of the voter registration form is only an application to apply to register to vote. The State Board of Elections shall approve the application to register to vote and send a confirmation or denial notice to the applicant.

 

      Section 7. Materials Incorporated by Reference. (1) Forms necessary for application for benefits under the Medicaid Program are incorporated effective April 1, 1995. These forms include the PA-1, revised October 1992; PA-1A, revised March 1991; PA-1C, revised October 1991; PA-1P, revised April 1992; PA-1UP, revised May 1991; and the KIM-100, revised March 1994.

      (2) These forms may be reviewed at the Department for Medicaid Services, 275 East Main Street, Frankfort, Kentucky 40621. Office hours are 8 a.m. to 4:30 p.m. Copies may be obtained upon payment of an appropriate fee which shall not exceed approximate cost. (21 Ky.R. 2592; Am. 22 Ky.R. 294; eff. 7-26-1995; Recodified from 907 KAR 1:610, 9-30-2013.)