53-6-195. Medicaid program for workers with disabilities -- purpose -- eligibility -- participant costs.
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53-6-195 . Medicaid program for workers with disabilities -- purpose -- eligibility -- participant costs.
(1)If appropriations specific for this purpose are provided by the legislature and federal approval of the necessary amendments to the state medicaid plan is secured, the department shall administer a medicaid program that allows individuals with disabilities to participate in the medicaid program if they obtain employment that increases their incomes above eligibility limits. Participants in the program may be required to pay a portion of the costs for participation. The purpose of the program is to support employment for individuals with disabilities by providing medicaid coverage to individuals who would otherwise be ineligible for medicaid due to earnings that exceed the medicaid program's income limits.
(2)The medicaid program provided for under this section must be implemented in accordance with the provisions of 42 U.S.C 1396a(a)(10)(A)(ii)(XIII) and (r)(2).
(3)An employed individual is eligible for the program if the individual:
(a)has a net family income that is less than 250% of the federal poverty level;
(b)would be categorically eligible for medicaid because the individual is disabled as defined under Title XVI of the Social Security Act, 42 U.S.C. 1382c, except that the person has or has had earnings above the level for substantial gainful activity;
(c)has income and resources equal to or below the income and resource limits established by the department by rule, which may be less stringent than the income and resource limits for supplemental security income benefits; and
(d)satisfies all other eligibility criteria established by the department by rule.
(4)The department may establish:
(a)requirements for the employment status of participants, the verification of employment status, and permissible temporary breaks in employment;
(b)requirements, limitations, and definitions pertaining to the income and resources of participants;
(c)only to the extent allowed under 42 U.S.C. 1396o, requirements for payment of premiums, deductions, and cost sharing as a condition for participating in the program.
(5)The department shall, to the extent allowed by appropriations levels and under applicable state and federal law, coordinate the medicaid program provided for under this section with other state and federal programs and resources that promote opportunities for persons with disabilities to retain, regain, and maintain employment.