This article is a section taken from MA under the TEFRA Option, a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.

Level of Care

Medical Assistance (MA) under the TEFRA option is for children with a disability who are otherwise ineligible for MA because household income is above the MA for Families with Children and Adults (MA-FCA) income limit. The TEFRA option for children with a disability is named after the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 that created the option.

The State Medical Review Team (SMRT) reviews all referrals for MA under TEFRA option to determine:

  • if the child is considered disabled according to the Social Security standards, and
  • if the child’s needs meet the level of care requirements.

The child must meet one of the following levels of care requirements:

  • Hospital
  • Intermediate care facility for people with developmental disabilities (ICF-DD)
  • Nursing facility

See the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Certification of Disability policy for more information.

Legal Citations

Code of Federal Regulations, title 42, section 1396A, subdivision e
Code of Federal Regulations, title 42, section 435.225
Minnesota Statutes, section 256B.055, subdivision 12
Minnesota Statutes, section 256B.092
The Tax Equity and Fiscal Responsibility Act (TEFRA), Public Law 97-248, section 134

CREDIT: The content of this post has been copied or adopted from the Minnesota Healthcare Programs Eligibility Policy Manual, originally published by the Minnesota Department of Human Services.

This is also part of a series of posts on Minnesota Healthcare Eligibility Policies.