reglab/statecodes huggingface dataset:
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-33 - Effective date of eligibility

Current through June, 2024
(a) The effective
				  date of eligibility for an applicant approved for medical assistance shall be
				  one of the following:
(1) The date the
				  application is received by the department; or
(2) For an individual approved as medically
				  needy, the date on which appropriate medical expenses, in accordance with
				  chapter 17-1730.1, were incurred; or
(3) The date on which all applicable
				  eligibility requirements are met by the applicant; or
(4) For a newborn of a beneficiary mother,
				  the date of the child's birth;
(5)
				  For a request for retroactive medical coverage of eligible services, the
				  applicant shall:
(A) Include the request for
				  retroactive coverage on the application; or
(B) Submit a written request to the
				  department within thirty calendar days from the date of the eligibility
				  determination; and
(C) The
				  effective date of coverage for eligible retroactive services received shall be
				  no earlier than the first day of the third month prior to the month the
				  application is received by the department for individuals applying for coverage
				  of long-term care services or ten calendar days immediately prior to the date
				  the application is received by the department for all other
				  individuals.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-34 - Notice of disposition of the application

Current through June, 2024
(a) A notice of
				  disposition of the application shall be sent under the provisions of chapter
				  17-1713.1.
(b) If determined
				  eligible for medical assistance, the individual shall be issued a Medicaid
				  identification card by the department as appropriate.
(c) For an individual determined ineligible
				  for Medicaid, the department shall transfer the individual's application
				  information for other insurance affordability programs as appropriate pursuant
				  to
				  42
				  C.F.R.
				  §435.1200(e).
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1712.1 - ELIGIBILITY RE-DETERMINATIONS › Section 17-1712.1-2 - Annual redetermination of a MAGI beneficiary

Current through June, 2024
(a) The
				beneficiary may request assistance with an annual redetermination under the
				provisions described in subchapter
				2 of chapter 171711.1.
(b) The annual redetermination of an
				individual or household, whose Medicaid eligibility is based on modified
				adjusted gross income methods (MAGI), shall be completed by the department no
				more frequently than once every twelve months.
(c) The annual redetermination of Medicaid
				eligibility shall be based on reliable information available to the department
				to include information through a federal or state database as described in
				chapter 17-1714.1, without requiring additional information from the
				beneficiary.
(d) If able to
				redetermine eligibility based on available information, the department shall
				notify the beneficiary as described under the provisions of chapter 17-1713.1,
				of the following:
(1) The eligibility
				redetermination decision and basis; and
(2) If the information is accurate, the
				beneficiary is not required to sign and return the notice; or
(3) If the information is not accurate, the
				beneficiary is required to correct, sign and return the notice.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1712.1 - ELIGIBILITY RE-DETERMINATIONS › Section 17-1712.1-3 - Annual redetermination of a MAGI-excepted beneficiary

Current through June, 2024
(a) The beneficiary may request assistance
				with an annual redetermination under the provisions as described in subchapter
				2 of chapter 17-1711.1.
(b) The
				annual redetermination of an individual or household whose Medicaid eligibility
				is based on MAGI-excepted methodology shall be completed by the department
				every twelve months.
(c) The
				department shall:
(1) Send a pre-populated
				redetermination form containing information available to the department to
				respond and provide necessary information, sign and return the form through any
				mode of communication, at least thirty days from the date the redetermination
				form is sent to the beneficiary in accordance with the provisions of chapter
				17-1711.1;
(2) Upon receipt of a
				signed redetermination form, verify the information provided by the
				beneficiary; and
(3) Inform the
				beneficiary of the eligibility decision under the provisions described in
				chapter 17-1713.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1712.1 - ELIGIBILITY RE-DETERMINATIONS › Section 17-1712.1-4 - Redetermination due to a change in beneficiary household circumstances

Current through June, 2024
(a) Between annual redeterminations of
				eligibility, an individual or household shall report any changes in
				circumstance that may affect eligibility through their elected mode of
				communication within ten days of the change.
(b) Upon receipt of the change in
				circumstance information, the department shall redetermine eligibility
				according to the provisions of sections 17-1712.1-2 or 17-1712.1-3, as
				applicable.
(c) For an individual
				determined eligible using MAGI-based methodology, the department shall:
(1) Limit requests for additional information
				solely to the reported change in circumstance;
(2) If able to redetermine eligibility of all
				requirements based on the reported change, a new twelve-month period of
				eligibility may be established;
(3)
				If informed of an anticipated change, redetermine eligibility at the
				appropriate time of the change;
(4)
				Process the addition of a new member to the household in accordance with
				paragraphs (b) and (c) of this section; and
(5) Prior to making a determination of
				ineligibility, determine all bases of eligibility under other chapters under
				this subtitle; and
(6) For an
				individual determined ineligible for Medicaid, the department shall transfer
				the individual's application information for other insurance affordability
				programs as appropriate pursuant to
				42
				CFR
				§435.1200(e).
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-1 - Purpose

Current through June, 2024
The purpose of this chapter is to establish the
				  circumstances, conditions, and deadlines under which the department shall
				  notify an individual regarding a determination of eligibility, level of
				  benefits or services, spenddown or premium amounts and adverse actions.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-2 - Notice of eligibility, or level of benefits and services

Current through June, 2024
(a) The department shall provide an
				individual with a written notice of any decision by the department or designee
				affecting the individual's eligibility for benefits and services approval,
				denial, termination, or suspension of benefits or services.
(b) The notice shall be written in plain
				language and be accessible to a person who is limited English proficient or has
				a disability.
(c) The notice
				content shall include that an individual's information may be transferred to
				all applicable insurance affordability programs.
(d) Effective January 1, 2015, for MAGI
				determinations, the department shall provide a combined eligibility notice in
				coordination with the Health Insurance Exchange.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-3 - Use of electronic notices

Current through June, 2024
(a) An individual
				shall be provided a choice to receive notices and information in electronic
				format in lieu of regular mail. When an electronic format is requested, the
				department shall:
(1) Confirm by regular mail
				the individual's election to receive notices electronically;
(2) Inform the individual of the right to
				change the election, at any time, to regular mail;
(3) Post notices to the electronic account
				within one business day of notice generation;
(4) Send an email or other electronic
				communication to alert the individual of the posting of a notice to their
				electronic account. No confidential information shall be contained in the email
				or electronic alert;
(5) If
				undeliverable, send the notice by regular mail within three (3) business days
				of the date of the failed electronic communication; and
(6) Provide, upon request, a paper-based
				notice sent through regular mail of any notice posted to the electronic
				account.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-4 - Notice content

Current through June, 2024
(a) A notice of
				approved eligibility includes, but is not limited to:
(1) The basis and effective date of
				eligibility;
(2) The circumstances
				and procedures under which reporting is required;
(3) If applicable, the amount of medical
				expenses which must be incurred to establish eligibility for medically needy
				spenddown;
(4) Information on the
				level of benefits and services approved, including, any premiums, enrollment
				fees and cost sharing; and
(5)
				Information on administrative appeal rights as described in chapter 17-1703.1
				to appeal eligibility or approved level of benefits and services.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-5 - Timely and adequate notice

Current through June, 2024
(a) Prior to the
				implementation of any adverse action which affects an individual, a timely and
				adequate notice shall be sent.
(b)
				A notice of adverse action shall be considered timely when sent:
(1) At least fifteen (15) calendar days prior
				to the effective date of adverse action except as described in paragraph (c).
				When a new address is reported to the department by the individual within the
				eligible period, a new notice shall be re-issued; or
(2) Five (5) calendar days prior to the
				effective date of adverse action when the department has evidence of probable
				fraud by the individual.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1713.1 - NOTICES › Section 17-1713.1-6 - Termination of eligibility

Current through June, 2024
(a) The department
				shall terminate an individual's eligibility and send notice of the adverse
				action when:
(1) A signed, written request
				for termination is received from the eligible individual;
(2) The department has verified the death of
				an eligible individual;
(3) The
				eligible individual is admitted or committed to a public institution;
(4) The eligible individual is no longer
				residing in the state;
(5) The
				eligible individual's whereabouts are unknown;
(6) The eligible individual, when required to
				meet the asset standard, fails to provide the department with verification to
				determine the amount of the assets;
(7) The eligible individual, whose
				eligibility determination is not based on the MAGI standard, fails to provide
				the department with verification to determine the amount of income;
(8) The eligible individual fails to apply
				for and develop potential sources of assets and income when required;
(9) An eligibility redetermination is not
				completed because of the eligible individual's failure to provide the
				department with requested verification or to provide a completed eligibility
				redetermination form when required;
(10) The eligible individual fails to meet
				any of the necessary requirements of the eligibility group; or
(11) The eligible individual fails to
				cooperate or provide information to federal or state personnel who review the
				decisions regarding eligibility for assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 1 - GENERAL PROVISIONS › Section 17-1714.1-1 - Purpose

Current through June, 2024
The purpose of this chapter is to establish the
					 non-financial general eligibility requirements for medical assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 1 - GENERAL PROVISIONS › Section 17-1714.1-2 - Right to assistance

Current through June, 2024
(a) The department
				  shall promptly provide medical assistance without delay to any individual or
				  household who meets all of the applicable eligibility requirements set forth by
				  subtitle 12.
(b) An individual
				  shall receive assistance unless determined ineligible for coverage due to the
				  individual's or household's failure to provide required verification or meet
				  all Medicaid eligibility requirements.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 1 - GENERAL PROVISIONS › Section 17-1714.1-3 - Evidence of identity

Current through June, 2024
(a) The department
				  shall verify the identity of an individual or household member prior to the
				  approval of assistance.
(b)
				  Verification of an individual's identity through a federal or State
				  governmental agency, including but not limited to a public assistance, law
				  enforcement, internal revenue or tax bureau, or corrections agency, or an
				  Express Lane agency, under section 1902 of the Social Security Act, shall be
				  accepted in lieu of documentation required under subsections (c), (d) and
				  (e).
(c) For an individual sixteen
				  years of age or older, the department shall accept the following as proof of
				  identity, provided the documentation has a photograph or other identifying
				  information including, but not limited to, name, age, sex, race, height,
				  weight, eye color, or address:
(1) Driver's
				  license issued by a state or U.S. territory;
(2) School identification card;
(3) U.S. military card or draft
				  record;
(4) Identification card
				  issued by the federal or state government;
(5) Military dependent's identification
				  card;
(6) Native American tribal
				  documents; or
(7) U.S. Coast Guard
				  Merchant Mariner card.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 1 - GENERAL PROVISIONS › Section 17-1714.1-4 - Determination of age

Current through June, 2024
(a) Verification of
				  an individual's age shall be required when age is a factor in determining
				  eligibility for medical assistance.
(b) Verification of an individual's age
				  through a federal or State electronic service as described in section
				  17-1714.1-12(b) shall be accepted in lieu of documentation required under
				  subsections (c) and (d).
(c) The
				  department may accept documentation that establishes citizenship or immigration
				  status or identity of an individual under subsections 17-1714.1-31(a), (b) and
				  (d) for purposes of establishing the age of an individual provided that such
				  documentation reflects the date of the birth of the individual.
(d) When documentary sources are not
				  available, the statements of relatives or friends who are knowledgeable of the
				  individual's circumstances may be accepted as verification of age. The
				  individual's record shall contain documentation of the:
(1) Name of the relatives or friends;
				  and
(2) Facts on which the
				  relatives' or friends' knowledge is based.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 2 - SOCIAL SECURITY NUMBER › Section 17-1714.1-10 - Purpose

Current through June, 2024
This subchapter establishes the requirement for a social
					 security number (SSN) for determining an individual's eligibility for medical
					 assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 2 - SOCIAL SECURITY NUMBER › Section 17-1714.1-11 - Furnishing of social security number

Current through June, 2024
(a) The department
				  shall require, as a condition of eligibility, that each individual applying for
				  medical assistance furnish a SSN, except as provided in paragraph
				  (c).
(b) If an individual is unable
				  to furnish a SSN or has not been issued a SSN, the department shall:
(1) Assist the applicant in completing an
				  application for a SSN;
(2) Obtain
				  evidence required under the SSA regulations to establish the age, citizenship
				  or non-citizen status, and the true identity of the individual; and
(3) Send the application to SSA or, if there
				  is evidence that the individual has previously been issued a SSN, request that
				  the SSA furnish the number.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 2 - SOCIAL SECURITY NUMBER › Section 17-1714.1-12 - Verification of SSN

Current through June, 2024
(a) The department
				  shall verify the SSN furnished by an individual with SSA to insure the SSN was
				  issued to that individual, and to determine whether any other SSNs were issued
				  to that individual.
(b) To the
				  extent that the SSN information is available through a federal or State
				  electronic service, the department shall obtain verification of the
				  individual's SSN information through the electronic service from SSA. For
				  purposes of this chapter, "federal electronic service" means a service
				  established by the federal government through which the department may verify
				  certain information with, or obtain such information from, federal agencies and
				  other data sources, including the SSA, Department of the Treasury, and the
				  Department of Homeland Security. A "state electronic service" means a service
				  established by the State through which the department may verify certain
				  information with, or obtain such information from, state agencies and other
				  data sources, including the Department of Labor, or other departments as
				  appropriate.
(c) If the department
				  is not able to verify the SSN through a federal or State electronic service,
				  the department shall verify the SSN through other means.
(d) The department shall not deny or delay
				  medical assistance to an individual who meets all other eligibility
				  requirements pending the issuance or verification of the individual's SSN by
				  the SSA or if the individual meets one of the exceptions in subsection
				  17-1714.1-11(c). The individual shall be required to report the SSN to the
				  department immediately upon receipt.
(e) When the SSN has been verified, the
				  department shall make a permanent entry to the individual's electronic account
				  to prevent the unnecessary reverification of the SSN.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 2 - SOCIAL SECURITY NUMBER › Section 17-1714.1-13 - Use of SSN

Current through June, 2024
The department shall notify the individual that the SSN is
					 required by section 1137(a)(1) of the Social Security Act (
					 42
					 U.S.C. §1320b - 7(a)(1) ) to:
(1) Verify income, eligibility, and benefits
				  for purposes of medical assistance through computer matches authorized under
				  the federal or State electronic services described in section 17-1714.1-12(b);
				  and
(2) Complete computer matching
				  to prevent duplicate participation or assistance, to facilitate mass changes in
				  federal benefits, and to verify the accuracy and reliability of the information
				  provided by the household under subchapter
				  5.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 3 - RESIDENCY AND INSTITUTIONAL STATUS › Section 17-1714.1-19 - Purpose

Current through June, 2024
The purpose of this subchapter is to describe how an
					 individual's state of residence is determined for purposes of establishing
					 eligibility for medical assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 3 - RESIDENCY AND INSTITUTIONAL STATUS › Section 17-1714.1-20 - Residency requirements

Current through June, 2024
(a) An individual
				  shall be considered to be a resident of the State when:
(1) Residing or expressing intent to reside
				  in the State, even if the individual does not have a fixed address;
(2) Has entered the State with a job
				  commitment or seeking employment (whether or not currently employed);
				  or
(3) Is in receipt of State
				  Supplementary Payment (SSP).
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 3 - RESIDENCY AND INSTITUTIONAL STATUS › Section 17-1714.1-21 - Eligibility requirements for a resident of a public institution

Current through June, 2024
(a) An individual shall not be eligible for
				  medical assistance when the individual is:
(1) An inmate in a public institution;
				  or
(2) Under age sixty-five who is
				  a resident or patient in an institution for mental disease or tuberculosis,
				  unless the individual is under age twenty-two and is in receipt of inpatient
				  psychiatric services.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 4 - CITIZENSHIP AND NON-CITIZENSHIP STATUS › Section 17-1714.1-27 - Purpose

Current through June, 2024
The purpose of this subchapter is to establish the types
					 of acceptable documentary evidence of citizenship and non-citizen status that
					 an individual or household shall meet to be eligible for Medicaid.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 4 - CITIZENSHIP AND NON-CITIZENSHIP STATUS › Section 17-1714.1-28 - Citizen and non-citizen eligibility

Current through June, 2024
(a) The following
				  individuals meet the citizenship and non-citizen requirements to be eligible
				  for Medicaid:
(1) A citizen of the U.S. who
				  has declared that the individual is a citizen or national of the U.S., and the
				  department has verified the declaration under section 17-1714.1-30. For
				  purposes of this subchapter, a citizen of the U.S. includes naturalized
				  citizens, members of a federally-recognized Indian Tribe, and individuals born
				  in the fifty states, the District of Columbia, Puerto Rico, Guam, American
				  Virgin Islands, American Samoa, Swain's Island, or the Commonwealth of the
				  Northern Mariana Islands.
(2) A
				  qualified non-citizen:
(A) Who is granted
				  asylum under section 208 of the INA (
				  8 U.S.C.
				  §
													1158 );
(B) Who is admitted to the U.S. as a refugee
				  under section 207 of the INA (
				  8
				  U.S.C. §
													1157 );
(C) Whose deportation is being withheld under
				  section 243(h) of the INA (
				  8 U.S.C. §
													1253, as in effect immediately before the
				  effective date of section 307 of division C of Public Law 104208 ) or section
				  241(b)(3) of the INA (
				  8 U.S.C.
				  §1231(b)(3), as amended
				  by section 305(a) of division C of
				  Public Law
				  104-208 ); or
(D) Who is a Cuban or Haitian refugee or
				  entrant as addressed in Title IV of the Immigration and Nationality Act and
				  section 501 of the Refugee Education Assistance Act.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 4 - CITIZENSHIP AND NON-CITIZENSHIP STATUS › Section 17-1714.1-29 - Declaration of citizenship and non-citizen status

Current through June, 2024
(a) The
				  department shall provide Medicaid to an otherwise eligible individual who is a
				  citizen:
(1) Provided the individual has
				  declared that the individual is a citizen or national of the United States, and
				  the department has verified such declaration;
(2) Except the following individuals are
				  exempt from the verification requirement in this subsection:
(A) An individual in receipt of foster care
				  services or benefits under Title IV-B or Title IV-E of the Social Security
				  Act;
(B) An individual entitled to
				  or enrolled in Medicare;
(C) An
				  individual in receipt of disability benefits under Title II of the Social
				  Security Act;
(D) An SSI recipient
				  under Title XVI of the Social Security Act; and
(E) A newborn for the first year of life who
				  is born to a Medicaid beneficiary mother.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 4 - CITIZENSHIP AND NON-CITIZENSHIP STATUS › Section 17-1714.1-30 - Verification of citizenship and non-citizen immigration status

Current through June, 2024
(a) The department shall verify citizenship
				  or non-citizen immigration status through the federal electronic service under
				  section 17-1714.1-12(b).
(b) If the
				  department is unable to verify citizenship or immigration status through the
				  federal electronic service, the department shall:
(1) Verify citizenship with acceptable
				  documentary evidence and in accordance with section 17-1714.1-31.
(2) Verify immigration status in accordance
				  with section 1137(d) of the Social Security Act (
				  42
				  U.S.C. §1320b - 7(d)(1)(B)(iii) ) and
				  the requirements of section 17-1714.1-31.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 4 - CITIZENSHIP AND NON-CITIZENSHIP STATUS › Section 17-1714.1-31 - Documentary evidence of citizenship

Current through June, 2024
(a) The following
				  documentary evidence of citizenship is acceptable:
(1) U.S. passport, including a U.S. Passport
				  Card issued by the Department of State, without regard to any expiration date
				  as long as the passport or Card was issued without limitation;
(2) A certificate of U.S.
				  citizenship;
(3) A certificate of
				  naturalization;
(4) A valid
				  state-issued driver's license if the state issuing the license requires proof
				  of U.S. citizenship, or obtains and verifies a social security number from the
				  applicant who is a citizen before issuing such license.
(5) Documentary evidence issued by a
				  federally recognized Indian Tribe, by the Bureau of Indian Affairs within the
				  U.S. Department of the Interior, and including Tribes located in a State that
				  has an international border which:
(A)
				  Identifies the federally recognized Indian Tribe that issued the
				  document;
(B) Identifies the
				  individual by name; and
(C)
				  Confirms the individual's membership, enrollment, or affiliation with the
				  Tribe.
(6) Documents
				  described in paragraph (5) above include, but are not limited to:
(A) A Tribal enrollment card;
(B) A certificate of degree of Indian
				  blood;
(C) A Tribal census
				  document; and
(D) Documents on
				  Tribal letterhead, issued under the signature of the appropriate Tribal
				  official, that meet the requirements of paragraph (5).
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 5 - ELIGIBILITY VERIFICATION › Section 17-1714.1-37 - Purpose

Current through June, 2024
This subchapter is to identify the federal, State or other
					 available data sources and how the department will use and process the
					 information obtained from these matches to determine eligibility for medical
					 assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 5 - ELIGIBILITY VERIFICATION › Section 17-1714.1-38 - General requirements

Current through June, 2024
(a) The department
				  shall accept self-attestation of an individual, attestation by an adult
				  individual who is in the applicant's household, an authorized representative,
				  or, if the individual is a minor, incapacitated or deceased, someone acting on
				  the applicant's behalf, without requiring further information or documentation,
				  except as allowed under section 17-1714.1-40 or where the law or this chapter
				  requires other procedures, such as for verifying citizenship, immigration
				  status, and SSN.
(b) The department
				  shall request and use information relevant to verifying an individual's
				  eligibility for Medicaid as described in this subchapter.
(c) The department shall furnish in a timely
				  manner income and eligibility information, subject to chapter 1702, required
				  for verifying eligibility to the following programs:
(1) Other agencies in the State and other
				  states and to the federal programs both listed in section 17-1711.1-34 and
				  identified in section 1137(b) of the Social Security Act;
(2) Other insurance affordability
				  programs;
(3) The child support
				  enforcement program under Part D of title IV of the Social Security Act;
				  and
(4) SSA for OASDI under title
				  II and for SSI under title XVI of the Social Security Act.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 5 - ELIGIBILITY VERIFICATION › Section 17-1714.1-39 - Verification of financial information

Current through June, 2024
(a) The department
				  shall request from other agencies in the State or other states and federal
				  programs the following information to verify financial eligibility of an
				  individual:
(1) Information related to wages,
				  net earnings from self-employment, unearned income and resources from the State
				  Wage Information Collection Agency (SWICA), the Internal Revenue Service(IRS),
				  the Social Security Administration (SSA), the agencies administering the State
				  unemployment compensation laws, the State-administered supplementary payment
				  programs under section 1616(a) of the Social Security Act, and any State
				  program administered under Titles I, X, XIV, or XVI of the Social Security Act;
				  and
(2) Information related to
				  eligibility or enrollment from the Supplemental Nutrition Assistance Program
				  (SNAP), the State program funded under Title IV-A of the Social Security Act,
				  and other insurance affordability programs.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1714.1 - GENERAL ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE › Subchapter 5 - ELIGIBILITY VERIFICATION › Section 17-1714.1-40 - Use of information and requests of additional information from an individual

Current through June, 2024
(a) The department
				  shall promptly evaluate the information it receives or obtains in accordance
				  with this chapter to determine whether the information may affect the
				  eligibility or benefits of an individual.
(b) If the information provided by or on
				  behalf of an individual is reasonably compatible with information obtained
				  through an electronic service, the agency shall determine or renew eligibility
				  based on such information.
(c) An
				  individual shall not be required to provide additional information or
				  documentation unless information needed by the department cannot be obtained
				  electronically or the information obtained electronically is not reasonably
				  compatible with information provided by or on behalf of the individual.
(1) Income information obtained through an
				  electronic service shall be considered reasonably compatible with income
				  information provided by or on behalf of an individual if both are either above,
				  at or below the applicable income standard or other relevant income threshold
				  within an amount as determined by the department.
(2) If the information provided by or on
				  behalf of an individual is not reasonably compatible with the electronic
				  service, the department shall pursue additional information from the
				  individual, including:
(A) A statement which
				  reasonably explains the discrepancy; or
(B) Other information, provided that
				  documentation from the individual is permitted only to the extent electronic
				  data is not available and establishing a data match through an electronic
				  service would not be feasible;
(C)
				  The department shall provide the individual a reasonable period to furnish any
				  additional information required under this subsection.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 1 - GENERAL PROVISIONS › Section 17-1715-1 - Purpose

Current through June, 2024
This chapter establishes the Children Group. The infants
					 and children under age nineteen group, commonly referred to as the Children
					 Group, created through the enactment of the Affordable Care Act, provides
					 Medicaid eligibility for individuals under age nineteen years, or under age
					 twenty-one years and in receipt of foster care, kinship guardianship, or
					 adoption assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 1 - GENERAL PROVISIONS › Section 17-1715-2 - General requirements

Current through June, 2024
The confidentiality, administrative appeal, fraud, medical
					 assistance recovery, application processing, eligibility review, and adverse
					 action provisions described in subtitle 12 shall pertain to an individual who
					 applies or is eligible under this chapter.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715-9 - Basic requirements

Current through June, 2024
An individual whose eligibility is being determined under
					 this chapter shall meet the basic eligibility requirements which include, but
					 are not limited to, citizenship, qualified non-citizen or lawfully present
					 non-citizenship status, State residency, verification of identity, not residing
					 in a public institution, and the provision of a social security number, as
					 described in chapter 17-1714.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715-10 - Categorical requirements

Current through June, 2024
(a) To be eligible
				  under the Children Group, an individual shall be:
(1) Under age nineteen years; or
(2) Under twenty-one years of age and in
				  receipt of non-Title IV-E or Title IV-E foster care, kinship guardianship, or
				  adoption assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715-11 - Income requirements

Current through June, 2024
(a) The modified
				  adjusted gross income (MAGI) methodology described in chapter 17-1724.2 shall
				  be used to determine the countable income for an individual subject to an
				  income limit.
(b) The income
				  standards for participation in the Children Group are:
(1) For a child under age one year, one
				  hundred eighty-five per cent of the federal poverty level for a household of
				  applicable size plus the income conversion percentage of six per
				  cent.
(2) For a child age one year
				  but under six years, one hundred thirty-three per cent of the federal poverty
				  level for a household of applicable size plus the income conversion percentage
				  of six per cent.
(3) For a child
				  age six years but under nineteen years, one hundred thirty-three per cent of
				  the federal poverty level for a household of applicable size.
(4) For an individual under age twenty-one
				  years who is a recipient of foster care, kinship guardianship, or adoption
				  assistance, no income limit shall apply.
An income disregard of five per cent of the applicable
					 federal poverty level, as cited in paragraphs (1) through (3), is added to the
					 highest income standard for an individual using MAGI-based methodology under
					 the applicable title of the Social Security Act.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715-13 - Eligibility review requirements

Current through June, 2024
(a) An eligible
				  child shall receive an annual eligibility review every twelve months.
(b) Eligibility shall be redetermined in
				  accordance with chapter 17-1712.1 and subchapter
				  5 of chapter 17-1714.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715-19 - Purpose

Current through June, 2024
This subchapter addresses and refers to the provisions of
					 freedom of choice, enrollment, benefits and disenrollment for an individual who
					 is eligible in accordance with this chapter.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715-20 - Freedom of choice

Current through June, 2024
(a) A child
				  eligible in accordance with this chapter, with the exception of a child
				  identified in section
				  17-1735.1-2(a),
				  shall be provided a choice of a health plan and a provider as described in
				  chapter 17-1720.1.
(b) A child
				  identified in section
				  17-1735.1-2(a)
				  shall choose a department approved provider as described in chapter
				  17-1736-3.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715-21 - Enrollment into a participating health plan

Current through June, 2024
(a) A child
				  eligible in accordance with this chapter, with the exception of a child
				  identified in section
				  17-1735.1-2(a),
				  shall be enrolled in a health plan as described in chapter 17-1720.1.
(b) A child identified in section
				  17-1735.1-2(a),
				  shall not be enrolled into a health plan and their healthcare services shall be
				  provided on a fee-for-service basis.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715-22 - Benefits

Current through June, 2024
(a) A child eligible in accordance with this
				  chapter who is enrolled in a health plan shall be provided a standard benefits
				  package by a participating health plan and other services when appropriate as
				  described in chapter 17-1720.
(b) A
				  child identified in section
				  17-1735.1-2(a)
				  shall be provided coverage under the fee-for-service provisions as described in
				  chapter 17-1737.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715 - CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715-23 - Disenrollment from a health plan

Current through June, 2024
An enrollee shall be disenrolled from a health plan under
					 the provisions as described in chapter 17-1720.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 1 - GENERAL PROVISIONS › Section 17-1715.1-1 - Purpose

Current through June, 2024
This chapter describes Medicaid eligibility for a former
					 recipient of foster care, kinship guardianship or adoption assistance who is
					 age eighteen but under age twenty-six years through the enactment of the Former
					 Foster Care Children Group under the provisions of the Affordable Care Act of
					 2010.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 1 - GENERAL PROVISIONS › Section 17-1715.1-2 - General requirements

Current through June, 2024
The confidentiality, administrative appeal, fraud, medical
					 assistance recovery, application processing, eligibility review, and adverse
					 action provisions described in subtitle 12 shall pertain to an individual who
					 applies or is eligible under this chapter.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715.1-9 - Basic requirements

Current through June, 2024
An individual who is a former recipient of foster care,
					 kinship guardianship or adoption assistance shall meet the following basic
					 requirements which include but are not limited to, citizenship, qualified or
					 lawfully present non-citizen, state residency, verification of identity, not
					 residing in a public institution and the provision of a social security number
					 as described in chapter 17-1714.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715.1-10 - Categorical requirements

Current through June, 2024
(a) An individual
				  eligible to participate in the Former Foster Care Children Group shall meet the
				  following requirements:
(1) Age eighteen but
				  under age twenty-six;
(2) Not
				  eligible for or in receipt of coverage under the provisions of any of the
				  following chapters:
(A)17-1715, Children
				  Group;
(B)17-1716, Pregnant Women
				  Group;
(C)17-1717, Parents or
				  Caretakers Relative Group; or
(D)17-1719, Aged, Blind or Disabled Group,
				  sections 17-1719-10(b)(1) and (b)(2);
(3) Was in receipt of foster care or placed
				  in kinship guardianship after attaining the age of sixteen or adopted after
				  attaining the age of sixteen, under a State's or Tribe's responsibility on the
				  date of attaining eighteen years of age or such higher age at which they became
				  ineligible for these programs; and (4) Was in receipt of Medicaid services
				  under the State Plan or the Hawaii 1115 demonstration waiver while receiving
				  foster care, kinship guardianship or adoption assistance.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715.1-11 - Income requirements

Current through June, 2024
Income shall not be considered in the determination of
					 eligibility for participation in the Former Foster Care Children
					 Group.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715.1-12 - Asset requirements

Current through June, 2024
Assets shall not be considered in the determination of
					 eligibility for participation in the Former Foster Care Children
					 Group.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 2 - ELIGIBILITY REQUIREMENTS › Section 17-1715.1-13 - Eligibility review requirements

Current through June, 2024
(a) An eligible
				  individual under this chapter shall receive an annual eligibility review every
				  twelve months.
(b) Eligibility
				  shall be redetermined in accordance with chapter 17-1712.1 and subchapter
				  5 of chapter 17-1714.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715.1-19 - Purpose

Current through June, 2024
This subchapter addresses and refers to the provisions of
					 freedom of choice, enrollment, benefits and disenrollment for an individual who
					 is eligible in accordance with this chapter.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715.1-20 - Freedom of choice

Current through June, 2024
(a) An individual
				  eligible under the provisions of this chapter, with the exception of an
				  individual identified in section 17-1735.1-2(a), shall be provided a choice of
				  health plan and a provider as described in chapter 17-1720.1.
(b) An individual identified in section
				  17-1735.1-2(a) shall choose a department approved provider as described in
				  section 17-1736-3.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1715.1 - FORMER FOSTER CARE CHILDREN GROUP › Subchapter 3 - FREEDOM OF CHOICE, ENROLLMENT, BENEFITS AND DISENROLLMENT › Section 17-1715.1-21 - Enrollment into a participating health plan

Current through June, 2024
(a) An
				  individual eligible in accordance with this chapter, with the exception of an
				  individual identified in section 17-1735.1-2(a), shall be enrolled in a health
				  plan as described in chapter 17-1720.1.
(b) An individual identified in section
				  17-1735.1-2(a) shall not be enrolled into a plan and their healthcare services
				  shall be provided on a fee-for-service basis.