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Public health emergency and Apple Health
In response to a public health or other emergencies beyond the agency’s control, the Health Care Authority (HCA) may invoke the following options via a State Plan Amendment, Disaster State Plan Amendment, waiver, or other federal regulation in the administration of the Medicaid program to implement changes to existing rule(s):
- Renewal dates may be extended for Apple Health coverage.
- Medically Needy (MN) coverage for individuals may be extended and attestation of medical expenses may be taken to meet spenddown amounts.
- Attestation of income and resources may be accepted to determine new and continued eligibility for all Apple Health programs.
- HCA may provide additional flexibility for clients when HCA is requesting information to process an application or a change of circumstances, including:
- Allowing more time to provide needed verifications;
- Allowing use of alternative verifications to verify circumstances; or
- Allowing flexibility for self-attestation in some situations including attesting to a disabling condition that could result in eligibility or documenting level of care.
- Premiums for the Apple Health for Workers with Disabilities and Apple Health for Kids with Premiums programs may be deferred, suspended, or waived, including past-due premiums.
- The treatment of income in the post eligibility process for long-term care may be adjusted in order to benefit clients.
- HCA may provide additional flexibility for individuals who file administrative hearing requests including:
- Suspending adverse actions resulting from an administrative hearing;
- Providing additional time for individuals to request an administrative hearing and to complete the administrative hearings process; and
- Allowing flexibility in requests for continued benefits.
- Terminations dates may be suspended or extended. When a termination is suspended or extended to a later date, HCA will follow existing notice and redetermination procedures before the termination may take effect.
- HCA may allow additional use of presumptive eligibility.
Changes to rules apply during the declared emergency period and expire upon termination of the emergency period including any extensions.
All changes to rules shall be applied uniformly.