Kansas Administrative Regulations › Agency 129 - KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT-DIVISION OF HEALTH CARE FINANCE › Article 6 - MEDICAL ASSISTANCE PROGRAM-CLIENTS' ELIGIBILITY FOR PARTICIPATION › Section 129-6-34 - Definitions; covered groups

Current through Register Vol. 43, No. 28, July 11, 2024
(a)
			 The terms defined in K.A.R. 129-1-1 shall be applicable to this article. In
			 addition and for purposes of this article, each of the following terms shall
			 have the meaning specified in this regulation, unless the context clearly
			 indicates otherwise:
(1) "Buy-in process"
			 means the process by which the medicaid program pays a recipient's medicare
			 premiums to establish medicare coverage.
(2) "Caretaker" means the person who is
			 assigned the primary responsibility for the care and control of the child and
			 who is any of the following persons:
(A)
			 Guardian, conservator, legal custodian, or person claiming the child as a tax
			 dependent;
(B) parent, including
			 parent of an unborn child;
(C)
			 sibling;
(D) nephew;
(E) niece;
(F) aunt;
(G) uncle;
(H) person of a preceding generation who is
			 denoted by a term that includes any of the following prefixes: "grand,"
			 "great-," "great-great-," or "great-great-great-";
(I) stepfather, stepmother, stepbrother, or
			 stepsister;
(J) legally adoptive
			 parent or another relative of an adoptive parent as listed in paragraph (a)(1);
			 and
(K) spouse of any person listed
			 in paragraph (a)(1) or former spouse of any of these persons, if marriage is
			 terminated by death or divorce.
(3) "Child" means a natural or biological
			 child, adopted child, or stepchild.
(4) "Earned income" means income, in cash or
			 in kind, that an applicant or recipient currently earns, through the receipt of
			 wages, salary, or profit, from activities in which the individual engages as an
			 employer or as an employee with responsibilities that necessitate continuing
			 activity on the individual's part.
(5) "Eligible caretaker" means a caretaker
			 who is considered in the assistance plan with the child.
(6) "Family group" means the applicant or
			 recipient and all individuals living together in which there is a relationship
			 of legal responsibility or a caretaker relationship.
(7) "HCBS" means home- and community-based
			 services. Home- and community-based services are medical and nonmedical
			 services provided to a medicaid recipient in the recipient's home that prevent
			 the recipient from being placed in a nursing facility, hospital, or
			 intermediate care facility.
(8)
			 "Household size" means the number of persons counted as members of an
			 individual's tax household in accordance with K.A.R. 129-6-41 and 129-6-53. For
			 each pregnant woman in the household, the household size shall include the
			 woman and the number of children she is expected to deliver.
(9) "Independent living" means any living
			 arrangement in which ongoing medical care or treatment is not routinely
			 provided, including living in one's own home, renting, living with other family
			 members or friends, living in a room-and-board arrangement, and living in
			 certain specialized living arrangements, including homeless shelters, shelters
			 for battered women, and alcohol and drug abuse facilities.
(10) "Legally responsible relative" means the
			 person who has the legal responsibility to provide support for the person in
			 the assistance plan.
(11)
			 "Long-term care" means care that is received in a nursing facility or other
			 institutional arrangement, a home- and community-based services arrangement, or
			 a program of all-inclusive care for the elderly (PACE) arrangement and whose
			 duration is expected to exceed the month the arrangement begins and the
			 following two months.
(12)
			 "Modified adjusted gross income" and "MAGI" mean income as defined in 26 U.S.C.
			 36B (d).
(13) "PACE" means program
			 of all-inclusive care for the elderly. The program of all-inclusive care for
			 the elderly provides medical services to frail elderly medicaid recipients in
			 institutional settings and non-institutional settings.
(14) "Parent" means natural or biological
			 parent, adoptive parent, or stepparent.
(15) "Protected income level" means the
			 amount of monthly income that is not considered available for the payment of
			 medical expenses. The protected income level is based on the number of persons
			 in the assistance plan in accordance with K.A.R. 129-6-42 and the number of
			 legally responsible relatives.
(16)
			 "Sibling" means natural or biological sibling, adopted sibling, half sibling or
			 stepsibling.
(17) "Supplemental
			 security income" and "SSI" mean the low-income assistance program administered
			 by the social security administration in accordance with 42 U.S.C. 1381 et
			 seq., which provides monthly benefits to elderly and disabled
			 persons.
(18) "Tax dependent" means
			 a dependent under 26 U.S.C. 152 for whom another individual claims a deduction
			 for a personal exemption under 26 U.S.C. 151 for a taxable year.
(19) "Title IV-E" means the adoption
			 assistance and child welfare act of 1980, which provides federal funding for
			 foster care, adoption assistance, and other permanency and placement programs
			 for children.
(20) "Unearned
			 income" means all income that is not earned income.