Appeals Archive

STATEMENT OF ISSUES The issue raised in this appeal is: Whether the Agency correctly determined Appellant is not eligible for Medical Assistance (MA) or MinnesotaCare coverage. Recommended decision: AFFIRM the Agency’s determination. PROCEDURAL HISTORY 1. On August 30, 2023, the Minnesota Health Care Programs (Agency) sent a Health Care Notice informing (Appellant) that he was not eligible for Medical Assistance (MA) or MinnesotaCare. 2 2. On September 30, 2023, Appellant submitted an appeal request. 3 3. On November 7, 2023, the human services judge held an evidentiary hearing on the matter by telephone conference. At the hearing, the Appellant requested the record be held open until November 9, 2023 to allow for the opportunity to submit additional documents. The record was held open until November 9, 2023 to receive any additional documents from Appellant. On November 9, 2023, additional documents were received from Appellant. 4 On November 9, 2023, the record closed consisting of the hearing testimony and three exhibits. 5

STATEMENT OF ISSUES The issue raised in this appeal is: Whether the Agency correctly determined Appellant is not eligible for Medical Assistance (MA) or MinnesotaCare coverage. Recommended decision: AFFIRM the Agency’s determination. PROCEDURAL HISTORY 1. On August 31, 2023, the Agency sent a Health Care Notice informing Appellant that she is not eligible for Medical Assistance (MA) or MinnesotaCare due to being over the program income limits. 2 2. On September 22, 2023, the Appeals Division received Appellant’s appeal request. 3 3. On November 3, 2023, the human services judge held an evidentiary hearing on the matter by telephone conference. At the hearing, Appellant requested the record be held open for the opportunity to submit additional documents. The record was held open until November 12, 2023 for Appellant to submit any additional documents. On November 10, 2023, additional documents were received from Appellant. 4 On November 12, 2023, the record closed consisting of the hearing testimony and three exhibits. 5

STATEMENT OF ISSUES The issues raised in this appeal are: 1) Whether Appellant timely appealed the Agency’s decision; and if so, 2) Whether the Department of Human Services correctly determined to close Appellant’s Medical Assistance (MA) for failure to renew. Recommended Decision: 1) No, the appeal was not timely requested and the matter must be dismissed. PROCEDURAL HISTORY 1. On June 30, 2023, the Department of Human Services (“Agency”) sent (“Appellant”)’s household a notice that Appellant’s MA would close effective July 31, 2023 for failure to renew. Exhibit 2. 2. On October 9, 2023, Appellant requested an appeal. Exhibit 1. 3. On November 14, 2023, Human Services Judge Wendy Sanchez held an evidentiary hearing via telephone conference. The record was held open to allow the parties time to exchange information. The record closed on December 6, 2023, consisting of hearing testimony and four exhibits. 2

STATEMENT OF ISSUES The issue raised in this appeal is: Did the agency correctly determine the appellant’s household was not eligible for Medical Assistance? Recommended Decision: No. When the appellant’s income dropped in October 2023, the household’s income went below the eligibility limit for its size. Therefore, the appellant is eligible for Medical Assistance beginning October 1, 2023. PROCEDURAL HISTORY 1. Notice of Action and Appeal Request. On September 5, 2023, the Minnesota Department of Human Services (agency) sent (appellant) written notice that they did not qualify for Medical Assistance. Exhibit 1. On August 31, 2023, the appellant filed an appeal. Exhibit 2. 2. Evidentiary Hearing. On November 3, 2023, Human Services Judge Patrick Kontz held an evidentiary hearing on the matter by telephone conference. The record was held open to allow the parties time to submit more evidence. On December 12, 2023, the record closed consisting of the hearing testimony and two exhibits. 2

STATEMENT OF ISSUES The issues raised in this appeal are: Whether the Department of Human Services correctly determined to close Appellant’s household’s Medical Assistance (MA) for failure to renew; and Whether the Department of Human Services correctly determined that Appellant’s household is ineligible for MA and MinnesotaCare because the household is over income. Recommended Decision: Yes, AFFIRM the Agency’s determination to close MA for failure to timely renew; and Yes, AFFIRM the Agency’s determination that Appellant’s household does not qualify for MA or MinnesotaCare, after reapplication. PROCEDURAL HISTORY 1. On August 8, 2023, the Department of Human Services (“Agency”) sent (“Appellant”) a notice that Appellant’s household’s MA would close effective August 31, 2023 for failure to renew. Exhibit 2. 2. On September 7, 2023, the Agency sent Appellant a notice that MA coverage would end September 30, 2023, rather than August 31, 2023. Exhibit 2. 3. On October 9, 2023, Appellant requested an appeal. Exhibit 1. 4. On November 15, 2023, Human Services Judge Wendy Sanchez held an evidentiary hearing via telephone conference. The record closed at the end of the hearing, consisting of hearing testimony and two exhibits. 2

STATEMENT OF ISSUE The issue raised in this appeal is: Whether the Department of Human Services correctly determined that not eligible for Medical Assistance or MinnesotaCare at redetermination. Recommended Decision: AFFIRM. The Department of Human Services correctly determined that not eligible for Medical Assistance or MinnesotaCare at redetermination. was was PROCEDURAL HISTORY 1. On August 24, 2023, the Minnesota Department of Human Services (Agency) sent (Appellant) a written notice of action informing Appellant that based on the renewal form information she is not eligible for Medical Assistance or MinnesotaCare, but is eligible for a Qualified Health Plan. 2 On September 25, 2023, Appellant filed an appeal. 3 2. On November 2, 2023, the Human Services Judge held an evidentiary hearing on the matter by telephone conference. The Human Services Judge held the record open to allow the parties to submit the fee-for-service notice. On November 13, 2023, the record closed consisting of the hearing testimony and four exhibits. 4

STATEMENT OF ISSUES The issue raised in this appeal is: Did the agency correctly determine the appellant’s household eligibility for the Minnesota Health Care Programs? Recommended Decision: Yes. The household’s income is above the eligibility limit for its size. PROCEDURAL HISTORY 1. Notice of Action and Appeal Request. On August 16, 2023, the Minnesota Department of Human Services (agency) sent (appellant) written notice that they were not eligible for Medical Assistance or MinnesotaCare. Exhibit 1. On August 16, 2023, the appellant filed an appeal. Exhibit 2. 2. Continuance. The hearing was initially scheduled for October 20, 2023; however, the appellant requested that the matter be continued to allow her time to try and resolve the matter with the agency. The judge granted the request. 3. Evidentiary Hearing. On November 21, 2023, Human Services Judge Patrick Kontz held an evidentiary hearing on the matter by telephone conference. The record was held open after the hearing to allow the appellant time to submit additional information about her household size and income. On December 1, 2023, the record closed consisting of the hearing testimony and two exhibits. 2

STATEMENT OF ISSUE The issue raised in this appeal is: Whether the Department of Human Services correctly determined not eligible for Medical Assistance or MinnesotaCare. Recommended Decision: AFFIRM. The Department of Human Services correctly determined not eligible for Medical Assistance or MinnesotaCare. was was PROCEDURAL HISTORY 1. On September 21, 2023, the Department of Human Services (Agency) sent (Appellant) a written notice of action informing the appellant that he was not eligible for Medical Assistance or MinnesotaCare, but was eligible for a qualified health plan either with or without advanced premium tax credits. 2 On October 2, 2023, Appellant filed an appeal. 3 2. On November 9, 2023, the human services judge held an evidentiary hearing on the matter by telephone conference. On November 9, 2023, the record closed consisting of the hearing testimony and two exhibits. 4