NOTICES
DEPARTMENT OF HEALTH
Chronic Renal Disease Program Eligibility Criteria
[33 Pa.B. 4852] The Department of Health (Department) hereby provides notice of intent to apply the following eligibility criteria to the Department's program as follows, effective September 29, 2003.
Disease or Condition
Coverage is provided for both children and adults who have end-stage renal disease. A written physician's verification of the diagnosis of end-stage renal disease is required.
Income
All new applicants must have an annual income of 0% to 250% of the Federal Poverty Income Guidelines as published by the United States Department of Health and Human Services (HHS) in the Federal Register and any revisions thereto (to the extent services are not covered by Medical Assistance). Current enrollees must meet the same eligibility criteria as new applicants at the time of renewal. A sliding fee scale will be applied to applicants with an annual income of 185% to 250% of the Federal Poverty Income Guidelines as published by the HHS in the Federal Register and any revisions thereto. Applicants must submit their most recent Federal 1040 tax return to verify annual income. If no Federal 1040 tax return was filed, other supporting documentation of annual income is required.
Resources
Verification of other health care resources, including other third party benefits such as Medical Assistance and insurance, is required.
Age
Children and adults of all ages are eligible for services.
Residency
Applicants must be United States citizens or legal aliens (admitted under the Immigration Reform and Control Act of 1986 (IRCA) or who qualify for refugee/asylum status) and Commonwealth residents for at least 90 consecutive days. Applicants who have not lived in this Commonwealth for 90 consecutive days will be considered residents for purposes of the Department if they can establish an intent to maintain a permanent home in this Commonwealth for the indefinite future. The following documentation must be submitted with the application and updated annually as necessary: birth certificate; naturalization papers or INS documents; and dated identification with a Commonwealth address and/or other verification, for example, public utility records and receipts, rent receipts, motor vehicle records, local tax records or completed and signed Federal or State income tax return with preprinted name and address.
Length of Eligibility
Eligibility is for a period of 1 year and will be re-evaluated annually.
Questions regarding this notice should be directed to Carolyn S. Cass, Director, Division of Child and Adult Health, Department of Health, P. O. Box 90, Harrisburg, PA 17108, (717) 783-5436. Persons with a disability may submit questions to Carolyn A. Cass in alternative formats, such as audiotape, Braille or TDD (717) 783-6514 or TT (800) 654-5984. Persons with a disability who require an alternative format of this document (for example, large print, audio tape or Braille) should contact Carolyn S. Cass to make the necessary arrangements.
CALVIN B. JOHNSON, M.D., M.P.H.,
Secretary
[Pa.B. Doc. No. 03-1903. Filed for public inspection September 26, 2003, 9:00 a.m.]
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