DHS presents Medicaid rule updates: newborn coverage clarification, sponsor‑deeming and a rate increase in home‑and‑community waiver

The Department of Human Services presented several administrative rule updates and a waiver renewal to the Senate Public Health committee on Sept. 8.

DHS said it would clarify newborn eligibility so infants born to mothers in the pregnancy coverage category qualify for the special newborn category that provides continuous coverage for the first 12 months and is not affected by changes in household income. DHS representatives said the only financial impact this year is an internal systems change to route newborns into the correct category.

DHS also proposed a clarification of sponsor‑deeming rules for lawfully admitted aliens who have sponsors: the policy makes explicit which parts of a sponsor’s income and household size are counted for MAGI or SSI eligibility determinations and allows certain deductions when the sponsor would otherwise apply for coverage for themselves.

Staff announced a minor cleanup to physician billing language in the provider manual (anesthesia billing coding clarification) and presented the renewal for the Our Choices Medicaid waiver (home‑and‑community‑based services) with limited substantive changes. The waiver renewal included an attendant‑care rate increase (15‑minute unit rate increase to align with personal care rates), citing prior rate reviews and minimum‑wage impacts; DHS said Milliman performed the rate work.

Committee members asked for timing and supporting analyses. DHS said rate work and waiver changes followed prior actuarial review and that additional technical materials are available to members on request. With no objections, the rules reported as reviewed were allowed to stand as reviewed and some items were held for the next meeting where paperwork needed correction.