SF1175

Purpose

Establish a presumptive disability determination process to determine eligibility for medical assistance. The bill creates a pathway to assess disability through Minnesota’s own process (the state medical review team) for people who may qualify for medical assistance based on disability, even if they have not yet been found disabled by the Social Security Administration (SSA).

Main Provisions

• Adds a new process to determine disability for medical assistance eligibility.
• Applies to individuals who are aged 65 or older or who would meet the SSI eligibility rules if not for excess income or assets, and who otherwise meet the general eligibility requirements for medical assistance.
• If an applicant is not aged or blind, does not meet any other eligibility category for medical assistance, and has not been determined disabled by SSA, they must be referred to Minnesota’s state medical review team to obtain a disability determination.
• This creates a formal referral step to the state medical review team as part of the medical assistance application process.

Significant Changes to Existing Law

• Amends Minnesota Statutes to insert a referral-and-determination mechanism for disability through the state medical review team, rather than relying solely on SSA disability determinations, for certain medical assistance applicants.
• Establishes incremental additions/subdivisions across multiple sections of the Minnesota Statutes to implement the presumptive disability determination process (e.g., sections 256B.055, 256B.056, 256B.057, 256B.0761, 256B.77, and related provisions).
• The new process is intended to speed up access to medical assistance for individuals with potential disabilities by providing an expedited disability review within Minnesota.

How the Change Works (Summary)

• A person who is 65+ or who meets SSI characteristics (or would, except for income/assets) and otherwise qualifies can receive medical assistance.
• If the person does not fit any other eligibility category and SSA has not already determined disability, they are forwarded to Minnesota’s state medical review team for a disability determination.
• The result of the state medical review team’s determination will guide eligibility for medical assistance under this pathway.

Beneficiaries and Impact

• Aimed at speeding up access to medical assistance for people who may be disabled but have not yet received SSA disability determination.
• Shifts a part of disability screening from SSA to Minnesota’s own state medical review process for certain applicants.
• Supports people who are aging (65+), blind, or otherwise disabled under SSI-related criteria in receiving timely medical coverage.

Relevant Terms - presumptive disability determination process - medical assistance eligibility - aged or blind - Social Security Administration (SSA) - Supplemental Security Income (SSI) - state medical review team - disability determination - Minnesota Statutes 2024 - excess income or assets - medical assistance pathway