907 KAR 20:075. Eligibility provisions

and requirements regarding former foster care individuals.

 

      RELATES TO: KRS 205.520

      STATUTORY AUTHORITY: KRS 194A.010(1), 194A.030(2),

194A.050(1), 205.520(3), 42 U.S.C. 1396a(a)(10)(A)(i)(IX).

      NECESSITY, FUNCTION, AND CONFORMITY: The

Cabinet for Health and Family Services, Department for Medicaid Services has

responsibility to administer the Medicaid Program. KRS 205.520(3) authorizes

the cabinet, by administrative regulation, to comply with any requirement that

may be imposed or opportunity presented by federal law to qualify for federal

Medicaid funds. This administrative regulation establishes the Medicaid

eligibility provisions and requirements for an individual between the age of

nineteen (19) and twenty-six (26) years, who formerly was in foster care and

was receiving Medicaid benefits at the time that the individual aged out of

foster care.

 

      Section 1. Former Foster Care Eligibility

Criteria. An individual between the age of nineteen (19) and twenty-six (26)

years, who formerly was in foster care, and was receiving Medicaid benefits at

the time the individual’s age exceeded the foster care age limit shall be

eligible for Medicaid benefits if the individual meets the requirements of

this administrative regulation.

 

      Section 2. Income Standard. There shall

be no income standard for individuals between the age of nineteen (19) and

twenty-six (26) years and who formerly were in foster care but aged out of

foster care.

 

      Section 3. Resource Standard. There shall

be no resource standard for individuals between the age of nineteen (19) and

twenty-six (26) years and who formerly were in foster care but aged out of

foster care.

 

      Section 4. Attestation of Having Aged Out

of Foster Care. (1) An individual between the age of nineteen (19) and

twenty-six (26) years, who formerly was in foster care, and was receiving

Medicaid benefits at the time the individual’s age exceeded the foster care age

limit, shall attest, during the application process, that the individual was receiving

Medicaid benefits at the time that the individual reached the age which exceeded

the foster care age limit.

      (2) An individual who does not attest as

established in subsection (1) of this section shall not be eligible for

Medicaid benefits under this administrative regulation.

 

      Section 5. Citizenship and Residency

Requirements. (1) The citizenship requirements established in 42 C.F.R. 435.406

shall apply.

      (2) To satisfy the Medicaid:

      (a) Citizenship requirements, an

applicant or recipient shall be:

      1. A citizen of the United States as

verified through satisfactory documentary evidence of citizenship or

nationality presented during initial application or if a current recipient,

upon next redetermination of continued eligibility;

      2. A qualified alien who entered the

United States before August 22, 1996, and is:

      a. Lawfully admitted for permanent residence

pursuant to 8 U.S.C. 1101;

      b. Granted asylum pursuant to 8 U.S.C.

1158;

      c. A refugee admitted to the United

States pursuant to 8 U.S.C. 1157;

      d. Paroled into the United States

pursuant to 8 U.S.C. 1182(d)(5) for a period of at least one (1) year;

      e. An alien whose deportation is being

withheld pursuant to 8 U.S.C. 1253(h), as in effect prior to April 1, 1997, or

8 U.S.C. 1231(b)(3);

      f. Granted conditional entry pursuant to

8 U.S.C. 1153(a)(7), as in effect prior to April 1, 1980;

      g. An alien who is granted status as a

Cuban or Haitian entrant pursuant to 8 U.S.C. 1522;

      h. A battered alien pursuant to 8 U.S.C.

1641(c);

      i. A veteran pursuant to 38 U.S.C. 101,

107, 1101, or 1301 with a discharge characterized as an honorable discharge and

not on account of alienage;

      j. On active duty other than active duty

for training in the Armed Forces of the United States and who fulfills the

minimum active duty service requirements established in 38 U.S.C. 5303A(d);

      k. The spouse or unmarried dependent

child of an individual described in clause i. or j. of this subparagraph or the

unremarried surviving spouse of an individual described in clause i. or j. of

this subparagraph if the marriage fulfills the requirements established in 38

U.S.C. 1304; or

      l. An Amerasian immigrant pursuant to 8

U.S.C. 1612(a)(2)(A)(v); or

      3. A qualified alien who entered the

United States on or after August 22, 1996 and is:

      a. Granted asylum pursuant to 8 U.S.C.

1158;

      b. A refugee admitted to the United

States pursuant to 8 U.S.C. 1157;

      c. An alien whose deportation is being

withheld pursuant to 8 U.S.C. 1253(h), as in effect prior to April 1, 1997, or

8 U.S.C. 1231(b)(3);

      d. An alien who is granted status as a

Cuban or Haitian entrant pursuant to 8 U.S.C. 1522;

      e. A veteran pursuant to 38 U.S.C. 101,

107, 1101, or 1301 with a discharge characterized as an honorable discharge and

not on account of alienage;

      f. On active duty other than active duty

for training in the Armed Forces of the United States and who fulfils the

minimum active duty service requirements established in 38 U.S.C. 5303A(d);

      g. The spouse or unmarried dependent

child of an individual described in clause e. or f. of this subparagraph or the

unremarried surviving spouse of an individual described in clause e. or f. of

this subparagraph if the marriage fulfills the requirements established in 38

U.S.C. 1304;

      h. An Amerasian immigrant pursuant to 8

U.S.C. 1612(a)(2)(A)(v); or

      i. An individual lawfully admitted for

permanent residence pursuant to 8 U.S.C. 1101 who has earned forty (40)

quarters of Social Security coverage; and

      (b) Residency requirements, the applicant

or recipient shall be a resident of Kentucky who meets the conditions for

determining state residency pursuant to 42 C.F.R. 435.403.

 

      Section 6. Provision of Social Security

Numbers. (1) Except as provided in subsections (2) and (3) of this section, an

applicant for or recipient of Medicaid shall provide a Social Security number

as a condition of eligibility.

      (2) An individual shall not be denied

eligibility or discontinued from eligibility due to a delay in receipt of a

Social Security number from the United States Social Security Administration if

appropriate application for the number has been made.

      (3) An individual who refuses to obtain a

Social Security number due to a well-established religious objection shall not

be required to provide a Social Security number as a condition of eligibility.

 

      Section 7. Institutional Status. (1) An

individual shall not be eligible for Medicaid if the individual is a:

      (a) Resident or inmate of a nonmedical

public institution except as established in subsection (2) of this section;

      (b) Patient in a mental hospital or

psychiatric facility unless the individual is:

      1. Under age twenty-one (21) years of

age; or

      2. Under age twenty-two (22) if the

individual was receiving inpatient services on his or her 21st birthday; or

      (c) Patient in a nursing facility classified

by the Medicaid program as an institution for mental diseases.

      (2) An inmate shall be eligible for

Medicaid during the period of time the inmate is admitted to a hospital if the

inmate:

      (a) Has been admitted to a hospital;

      (b) Has been an inpatient at the hospital

for at least twenty-four (24) consecutive hours; and

      (c) Meets the Medicaid eligibility

criteria established in this administrative regulation.

 

      Section 8. Application Process, Initial

and Continuing Eligibility Determination. (1) An individual may apply for

Medicaid benefits by:

      (a) Using the Web site located at www.kynect.ky.gov;

      (b) Applying over the telephone by

calling:

      1. 1-855- 459-6328; or

      2. 1-855-326-4654 if deaf or hearing

impaired;

      (c) Faxing an application to 1-502-573-2007;

      (d) Mailing a paper application to Office

of Health Benefits Exchange, 12 Mill Creek, Frankfort, Kentucky 40601; or

      (e) Going to the applicant’s local

Department for Community Based Services Office and applying in person.

      (2) An individual shall attest in

accordance with Section 4 of this administrative regulation when applying for

Medicaid benefits.

      (3)(a) An application shall be processed

(approved, denied, or a request for additional information sent) by the

department or other entity involved in processing the given application within forty-five

(45) days of application submittal.

      (b) If a trusted source indicates that an

applicant is incarcerated, a request for additional information shall be

generated by the department or other entity involved in processing the

application requesting verification of the applicant’s incarceration dates or

status.

      (c) If an applicant fails to provide

information in response to a request for additional information within

forty-five (45) days of the receipt of the request, the application shall be

denied.

 

      Section 9. Adverse Action, Notice, and Appeals.

The adverse action, notice, and appeals provisions established in 907 KAR

20:060 shall apply to former foster care individuals between the age of nineteen

(19) and twenty-six (26) who aged out of foster care while receiving Medicaid

coverage. (40 Ky.R. 1209; Am. 1801; 2178; 4-4-2014.)