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 129-6-53 - Financial eligibility for MAGI-based coverage groups
Universal Citation: KS Admin Regs 129-6-53
Current through Register Vol. 43, No. 12, March 20, 2024
This regulation shall apply to all groups described in K.A.R. 129-6-34(c)(1).
(a) Definitions. For purposes of this regulation, each of the following terms shall have the meaning specified in this regulation.
(1) "Household income" means
the sum of the MAGI-based income of every individual included in the
individual's household minus an amount equivalent to five percentage points of
the federal poverty level for the applicable family size, for purposes of
determining the individual's eligibility under the highest income standard for
which the individual is eligible.
(2) "MAGI-based income" means income
calculated using the same financial methodologies used to determine MAGI as
defined in 26 U.S.C. 36B(d), with the following exceptions:
(A) An amount received as a lump sum shall be
counted as income only in the month received;
(B) scholarships, awards, or fellowship
grants used for education purposes and not for living expenses shall be
excluded from income; and
(C) for
American Indian and Alaska native funds, the following shall be excluded from
income:
(i) Distributions from Alaska native
corporations and settlement trusts;
(ii) distributions from any property held in
trust, subject to federal restrictions, located within the most recent
boundaries of a prior federal reservation or otherwise under the supervision of
the secretary of the interior;
(iii) distributions and payments from rents,
leases, rights-of-way, royalties, usage rights, or natural resource extraction
and harvest from rights of ownership or possession in any lands described in
this paragraph or federally protected rights regarding off-reservation hunting,
fishing, gathering, or usage of natural resources;
(iv) distributions either resulting from real
property ownership interests related to natural resources and improvement
located on or near a reservation or within the most recent boundaries of a
prior federal reservation or resulting from the exercise of federally protected
rights relating to these real property ownership interests;
(v) payments resulting from ownership
interests in or usage rights to items that have unique religious, spiritual,
traditional, or cultural significance or rights that support subsistence or a
traditional lifestyle according to applicable tribal law or custom;
and
(vi) student financial
assistance provided under the bureau of Indian affairs education
programs.
(b) Exceptions to household income. Financial eligibility for families and children shall be based on household income, except for the following:
(1) The MAGI-based
income of an individual who is included in the household of the individual's
natural parent, adoptive parent, or stepparent and is not expected to be
required to file a tax return under 26 U.S.C. 6012(a) for the taxable year in
which eligibility is being determined shall not be included in household income
whether ornot the individual files a tax return.
(2) The MAGI-based income of a tax dependent
described in K.A.R. 129-6-41(e)(1) who is not expected to be required to file a
tax return under 26 U.S.C. 6012(a) for the taxable year in which eligibility is
being determined shall not be included in household income whether ornot the
tax dependent files a tax return.
(c) Income deductions. No other deductions shall be applied in determining household income.
(d) Financial eligibility.
(1) Financial eligibility shall be based on
the current monthly income and family size of the household, unless a change in
circumstances is expected. In this case, financial eligibility shall be based
on the projected monthly income and family size of the household.
(2) For children and pregnant women
determined eligible based on K.A.R. 129-6-73 and K.A.R. 129-6-74, the
provisions of K.A.R. 129-6-54(a), (b), (c), and (e) regarding base periods and
spenddown determinations shall be applicable.
(e) Exclusion of resources. The value of the household's resources shall not be taken into consideration in determining financial eligibility.
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