17-1723.2

UNOFFICIAL
1723.2-1
HAWAII ADMINISTRATIVE RULES
TITLE 17
DEPARTMENT OF HUMAN SERVICES
SUBTITLE 12
MED-QUEST DIVISION
CHAPTER 1723.2
REFUGEE MEDICAL ASSISTANCE
Subchapter 1 	General Provisions
§17-1723.2-1 	Purpose
§17-1723.2-2 	General requirements
§§17-1723.2-3 to 17-1723.2-7 	(Reserved)
Subchapter 2 	Refugee Medical Assistance (RMA)
Program
§17-1723.2-8 	Purpose
§17-1723.2-9 	Basic requirements
§17-1723.2-10 	Categorical requirements
§17-1723.2-11 	Income requirements
§17-1723.2-12 	Asset requirements
§17-1723.2-13 	Redetermination of eligibility
§17-1723.2-14 	Records
§§17-1723.2-15 to 17-1723.2-19 	(Reserved)
Subchapter 3 	Freedom of Choice, Enrollment,
Benefits, Disenrollment and
Termination of Assistance
§17-1723.2-20 	Purpose
§17-1723.2-21 	Freedom of choice
§17-1723.2-22 	Enrollment into a participating
health plan
§17-1723.2-23 	Benefits
§17-1723.2-24 	Disenrollment from a health plan

UNOFFICIAL
1723.2-2
§17-1723.2-25 	Termination of assistance
§§17-1723.2-26 to 17-1723.2-30 	(Reserved)
SUBCHAPTER 1
GENERAL PROVISIONS
§17-1723.2-1 Purpose. 	The purpose of this
chapter is to establish the requirements for
eligibility and participation in the Refugee Medical
Assistance (RMA) program. 	[Eff 	09/30/13] 	(Auth:
HRS §§346-14, 346-56; 45 C.F.R. §§400.90, 400.91)
(Imp: 	HRS §§346-14, 346-56; 45 C.F.R. §§400.90,
400.91)
§17-1723.2-2 	General requirements. 	The
confidentiality, administrative appeal, fraud, medical
assistance recovery, application processing,
eligibility review, and adverse action notice
provisions described in subtitle 12 shall pertain to
an individual who applies or is eligible under this
chapter. 	[Eff 	09/30/13] 	(Auth: 	HRS §§346-14, 346-
44; 42 C.F.R. §§431.200, 431.206, 431.221, 431.230,
431.300, 435.907, 435.916, 455.1) (Imp: 	HRS §§346-14,
346-44; 42 C.F.R. §§431.200, 431.206, 431.221,
431.230, 431.300, 435.907, 435.916, 455.1)
§§17-1723.2-3 to 17-1723.2-7 	(Reserved).
SUBCHAPTER 2
REFUGEE MEDICAL ASSISTANCE (RMA) PROGRAM
§17-1723.2-8 	Purpose. This subchapter describes
the eligibility requirements for Refugee Medical
Assistance (RMA). 	[Eff 	09/30/13] 	Auth: 	HRS §§346-
14, 346-56, 45 C.F.R. §§400.90, 400.91) (Imp: 	HRS
§§346-14, 346-56, 45 C.F.R. §§400.90, 400.91)

UNOFFICIAL
1723.2-3
§17-1723.2-9 	Basic Requirements. 	An individual
applying for assistance under this subchapter shall
meet the following basic requirements, which include
but are not limited to non-citizen status, state
residency, verification of identity, not residing in a
public institution, and the provision of a social
security number when applicable. 	[Eff 	09/30/13]
(Auth: 	HRS §346-14; 42 C.F.R. §§435.10, 435.400,
435.910; 45 C.F.R. §§400.90, 400.100) (Imp: 42 C.F.R.
§§435.400, 435.910; 45 C.F.R. §§400.90, 400.100)
§17-1723.2-10 	Categorical requirements. 	An
individual eligible to participate in the Refugee
Medical Assistance program shall:
(1) 	Be ineligible for medical assistance under
the provisions of chapters 17-1715, 17-1716,
17-1717, 17-1718, 17-1719 or 17-1730.1 with
the following income not considered:
(A) 	In-kind services and shelter provided
by a sponsor or local resettlement
agency;
(B) 	Cash allotments provided by the
resettlement agency and financial cash
assistance payments provided by the
department; and
(C) 	Income remaining in the country of
origin;
(2) 	Provide documentation issued by the USCIS
that the individual is:
(A) 	Paroled as a refugee or asylee under
section 212(d)(5) of the INA;
(B) 	Admitted as a refugee under section 207
of the INA;
(C) 	Granted asylum under section 208 of the
INA;
(D) 	A Cuban or Haitian entrant, in
accordance with the requirements in 45
C.F.R Part 401;
(E) 	An Amerasian from Vietnam who is
admitted to the U.S. as an immigrant
pursuant to section 584 of the Foreign

UNOFFICIAL
1723.2-4
Operations, Export Financing and
Related Programs Appropriations Act of
1988 (Pub. L. 100-202, section 101(e))
and succeeding amendments; or
(F) 	Admitted for permanent residence,
provided the individual previously held
one of the statuses identified above.
(3) 	An individual who meets any of the
requirements in section 17-1723.2-10(2)
shall be referred to as a “refugee” in this
chapter.
(4) 	Provide the name of the resettlement agency
which resettled them in order for the
department to notify the agency upon receipt
of an application.
(5) 	Not be a full-time student in higher
education, unless part of an employability
plan for a refugee under 45 C.F.R. §400.79
or for an unaccompanied minor under 45
C.F.R. §400.112. 	[Eff 	09/30/13] 	(Auth:
HRS §§346-14, 346-56, §101(a)(42) of the
INA, 45 C.F.R. §§400.43, 400.90, 400.100,
400.101, 400.102) (Imp: 	HRS §§346-14, 346-
56, §101(a)(42) of the INA, 45 C.F.R.
§§400.43, 400.90, 400.100, 400.101, 400.102)
§17-1723.2-11 	Income Requirements. 	(a) Income
shall be based on information as of the date of
application. 	The department may not employ
prospective averaging of income methodology.
(b) 	A refugee ineligible under section 17-
1723.2-10 due to excess income under chapters 17-1715,
17-1716, 17-1717, 17-1718, 17-1719, or 17-1730.1 is
eligible under the provisions of this chapter if able
to spend down to the applicable standard through
incurred medical expenses.
(c) 	A refugee initially determined eligible
under chapters 17-1715, 17-1716, 17-1717, 17-1718, 17-
1719 or 17-1730.1 who is subsequently terminated due
to earnings from employment shall be transferred to

UNOFFICIAL
1723.2-5
the Refugee Medical Assistance program without a
determination of eligibility, until the end of the
time-limited period for RMA.
(d) 	Earned income shall not affect continued
eligibility for a refugee initially determined
eligible for RMA.
(e) 	A refugee who is sixty-five years or older,
or who is blind or disabled, shall be referred to the
Social Security Administration to apply for
Supplemental Security Income (SSI) and Medicare as
appropriate.
(f) 	For an individual determined ineligible under
this chapter, the department shall transfer the
individual's application information for other insurance
affordability programs as appropriate pursuant to 42
C.F.R. §435.1200(e). 	[Eff 	09/30/13] 	(Auth: 	HRS
§§346-14, 346-56; 42 C.F.R. §§435.10, 435.100, 435.1200,
45 C.F.R. §§400.100, 400.101, 400.102, 400.103, 400.104)
(Imp: 	HRS §346-56, 42 C.F.R. §§435.10, 435.100,
435.1200, 45 C.F.R. §§400.100, 400.101, 400.102,
400.103, 400.104)
§l7-1723.2-12 	Asset requirements. 	Assets shall
be considered as follows:
(1) 	For a non-ABD individual, apply the asset
provisions described in chapters 17-1715,
17-1716, 17-1717, 17-1718, or 17-1730.1 as
applicable.
(2) 	For an ABD individual, apply the asset
provisions described in chapter 17-1719.
[Eff 	09/30/13] 	(Auth: 	HRS §§346-14, 346-
56; 45 C.F.R. §§400.100, 400.101, 400.102,
400.103) (Imp: 	HRS §346-56, 45 C.F.R.
§§400.100, 400.101, 400.102, 400.103)
§17-1723.2-13 	Redetermination of eligibility.
The provisions of section 17-1712.1-4 relating to
redeterminations of eligibility due to a change in
household circumstances shall apply to an individual
eligible under this chapter. 	[Eff 	09/30/13] 	(Auth:
HRS §§346-14, 346-56; 42 C.F.R. §§431.10,

UNOFFICIAL
1723.2-6
435.916, 45 C.F.R §§400.93, 400.94) (Imp: 	HRS §346-
56; 42 C.F.R. §§431.10, 435.916, 45 C.F.R §§400.93,
400.94)
Historical note: 	§17-1723.2-13 is based substantially
upon §17-1723-18. 	[Eff 08/01/94; R 09/30/13]
§17-1723.2-14 	Records. 	The following
information shall be entered in the record of each
refugee:
(l) 	The name and address of the sponsor;
(2) 	The name of the national voluntary
resettlement agency which resettled the
refugee or the absence of an involved
voluntary resettlement agency; and
(3) 	The passport or alien registration number on
the form I-94. 	[Eff 	09/30/13] 	(Auth: 	HRS
§346-14, §346-56; 45 C.F.R. §§ 400.93,
400.100) (Imp: 	HRS §346-56; 45 C.F.R. §§
400.93, 400.100)
Historical note: 	§17-1723.2-14 is based substantially
upon §17-1723-17. 	[Eff 08/01/94; [R 09/30/13]
§§17-1723.2-15 to 17-1723.2-19 	(Reserved).
SUBCHAPTER 3
FREEDOM OF CHOICE, ENROLLMENT, BENEFITS, DISENROLLMENT
AND TERMINATION OF ASSISTANCE
§17-1723.2-20 	Purpose. 	This subchapter addresses
and refers to the provisions of freedom of choice,
enrollment, benefits and disenrollment for a refugee
who is eligible for RMA under this chapter.
[Eff 	09/30/13] 	(Auth: HRS §346-14; 42 C.F.R.
§§430.25, 431.10, 431.40, 435.10; 45 C.F.R. §§400.90,
400.105) (Imp: 42 C.F.R §§430.25, 431.10, 431.40, 45
C.F.R. §§400.90, 400.105)

UNOFFICIAL
1723.2-7
§17-1723.2-21 	Freedom of choice. 	(a) 	A refugee
eligible in accordance with this chapter, with the
exception of a refugee identified in section 17-
1735.1-2(a), shall be provided a choice of a health
plan and a provider as described in chapter 17-1720.1.
(b) 	A refugee identified in section 17-1735.1-
2(a) shall choose a department approved provider as
described in 17-1736-3. 	[Eff 	09/30/13] 	(Auth: 	HRS
§§346-14, 346-56; 42 C.F.R. §§430.25, 431.51, 438.52;
45 C.F.R. §400.105) (Imp: 	HRS §346-56; 42 C.F.R.
§§430.25, 431.51, 438.52; 45 C.F.R. §400.105)
§17-1723.2-22 	Enrollment into a participating
health plan. 	(a) 	A refugee eligible in accordance
with this chapter, with the exception of a refugee
identified in section 17-1735.1-2(a), shall be
enrolled in a health plan as described in chapter
17-1720.1.
(b) 	A refugee identified in section 17-1735.1-
2(a) shall not be enrolled into a health plan and
their health care services shall be provided on a fee-
for-service basis. 	[Eff 	09/30/13] 	(Auth: 	HRS
§§346-14, 346-56; 42 C.F.R. §§430.25, 431.10, 431.40,
438.50, 45 C.F.R. §400.105) (Imp: 	42 C.F.R. §§430.25,
431.10, 431.40, 438.50, 45 C.F.R. §400.105)
§17-1723.2-23 	Benefits. (a) 	Benefits under this
chapter shall be time-limited as determined by the
Director of the federal Office of Refugee
Resettlement.
(b) 	A refugee who is enrolled in a health plan
shall be provided a standard benefits package by a
participating health plan and other services when
appropriate as described in chapter 17-1720.
(c) 	A refugee identified in section 17-1735.1-
2(a) shall be provided coverage under the fee-for-
service provisions as described in chapter 17-1737.
[Eff 	09/30/13] 	(Auth: 	HRS §346-14; 42 C.F.R.
§§430.25, 431.40, 438.6; 45 C.F.R. §400.105) (Imp:

UNOFFICIAL
1723.2-8
HRS §346-14; 42 C.F.R. §§430.25, 431.40, 438.6; 45
C.F.R. §400.105)
§17-1723.2-24 	Disenrollment from a health plan.
An enrollee shall be disenrolled from a health plan
under the provisions as described in chapter 17-
1720.1. 	[Eff 	09/30/13] 	(Auth: 	HRS §346-14; 42
C.F.R. §430.25, 431.40, 438.56, 45 C.F.R. §400.105)
(Imp: 	HRS §346-14; 42 C.F.R. §430.25, 431.40, 438.56,
45 C.F.R. §400.105)
§17-1723.2-25 	Termination of assistance. 	(a)
After a refugee is determined eligible for RMA under
this chapter, the department shall review the
refugee’s circumstances as appropriate for changes to
determine eligibility for other medical assistance
programs.
(b) 	Refugee Medical Assistance shall be
terminated when the first of the following conditions
is met:
(1) 	The refugee has been determined eligible for
Medicaid;
(2) 	Countable assets exceed the maximum
allowable; or
(3) 	The last day of the final month of the time
limited benefit period.
(c) 	When RMA is terminated, the department shall
transfer the individual's application information for
other insurance affordability programs as appropriate
pursuant to 42 C.F.R. §435.1200(e).
[Eff 	09/30/13] 	(Auth: 	HRS §346-14; 42 C.F.R.
§§431.200, 431.213, 435.1200; 45 C.F.R. §§400.94,
400.100) (Imp: 	HRS §346-14; 42 C.F.R. §§431.200,
431.213, 435.1200; 45 C.F.R. §§400.94, 400.100)
§§17-1723.2-26 to 17-1723.2-30 	(Reserved).