Adult Medicaid Admin. Letters
DMA ADMINISTRATIVE LETTER NO: 11-05, EMERGENCY MEDICAID PROCEDURES FOR HURRICANE EVACUEES ADDENDUM 3
DATE: SEPTEMBER 30,2005
SUBJECT: EMERGENCY MEDICAID PROCEDURES FOR HURRICANE
DISTRIBUTION: COUNTY DIRECTORS OF SOCIAL SERVICES
In response to the destruction resulting from Hurricanes Rita and Katrina, North Carolina Medicaid is helping to coordinate efforts to provide essential services for Medicaid recipients who have evacuated to North Carolina from Louisiana (LA), Mississippi (MS), Alabama (AL), and Texas (TX). This letter is revised to give information on how to handle Hurricane Rita evacuees.
This letter provides guidance and procedures regarding assisting the displaced Louisiana, Mississippi, Alabama, and Texas Medicaid and Health Choice recipients evacuating to North Carolina. Each county DSS must take and process applications for Medicaid and Health Choice for these individuals.
A. Information Concerning Hurricane Katrina Evacuees
1. The application period for evacuees of Hurricane Katrina has been extended through January 31, 2006. This means that Katrina evacuees have until January 31, 2006, to apply for Medicaid coverage.
2. The application processing time standard for Katrina Emergency Medicaid applicants remains 5 work days.
3. Katrina evacuees who meet North Carolina eligibility requirements are now eligible for up to 5 months of Medicaid or North Carolina Health Choice (NCHC) coverage.
4. For those Katrina cases authorized through November 30, 2005, you must now extend the certification period so that the recipient receives 5 months of Medicaid. An eligibility determination is not required.
a. Refer to your Case Management Report.
b. Reenter the Special Use Code and begin date. Enter the fifth month as the Special Use end date. For example, an evacuee applied in October and was found eligible. October is the first month of coverage. The original certification period was through November 30, 2005. The new certification period is December 1, 2005, through February 28, 2006.
c. Exception: For NC Health Choice, the certification period is already 12 months. The Special Use end date should be the fifth month. Re-enter the Special Use Code and begin date. Enter the fifth month of eligibility as the end date.
d. Change the address from the county DSS to the recipient’s home address, if known.
5. Retroactive months are included in the five-month eligibility period, with the exception of August. For individuals whose Medicaid began in August, begin counting the five-month eligibility period with September. These individuals will actually receive six months of coverage.
6. In the fourth month of the certification period, complete a review using regular Medicaid or NCHC eligibility criteria.
a. Begin the review process in time to allow a timely notice period to expire prior to pull date in the last month of the certification period, or the fifth month of eligibility for NCHC.
b. Terminate the case at the end of the certification period when the recipient has not provided required information. Allow for timely notice.
B. Information Concerning Hurricane Rita Evacuees
1. For individuals that are displaced by Hurricane Rita, their applications are to be handled as regular Medicaid applications.
2. Treat applications taken for Rita evacuees in the same manner as an application taken for any individual moving to North Carolina from another state.
a. Verify Texas benefits by calling 1-512-438-3280.
b. Verify Louisiana benefits by calling 1-888-524-3578.
3. The 45/90 day processing period applies; however, counties are urged to act on these applications as quickly as possible.
4. Enter the applicant’s address on the 8125. If the applicant is in a shelter, use the address of the county DSS agency. Applicants residing in a shelter must pick up their Medicaid card each month at the county DSS.
5. Applicants who state their intent to remain in North Carolina for an indefinite period of time (until they are able return to their home state) meet the State residency requirement.
ii. policy principles
A. Waived Requirements
The following requirements are waived for Katrina Emergency Medicaid
1. Medicaid termination in AL, MS or LA,
2. Verification requirements excluding possible online verifications, and
3. State residency.
B. Accept applicant’s statement for income and assets if verification is not available. Use SOLQ to verify SSA and SSI.
III. SPECIAL POLICY PROCEDURES FOR KATRINA AND RITA EVACUEES
A. Accept the applicant’s statement for county/parish and state residence. The applicant must complete and sign the Application for Temporary Medicaid for Hurricane Evacuees, Attachment 1.
B. If a social security number is unknown or unavailable, use zeros. Verify the social security number using SOLQ. Follow procedures in the Enumeration Procedures section of MA-3355 or MA-2450.
C. Document a local contact address in the case file, if needed, for future notifications.
D. Applicants for Emergency Medicaid for Hurricanes Katrina and Rita are exempt from Carolina Access. Enter the exempt code 9900030 in EIS. Mecklenburg County should enter the exempt code 9900040.
E. Special Indicator Code
1. Katrina Evacuees
a. At the individual level in EIS, enter an Individual Special Use Code of AL (for Alabama), MS (for Mississippi), and LA (for Louisiana).
b. In the Date field beside the Individual Special Use code, enter the first and last month of eligibility. The last month of eligibility will be the fifth month, or the sixth month, if August is included in the eligibility period. For example, an application taken in September with August retro eligibility would have dates entered 082005012006. An application taken in September with no retro eligibility would have dates entered 092005012006.
2. Rita Evacuees
a. At the individual level in EIS, enter an Individual Special Use Code of LR (for Louisiana evacuees from Hurricane Rita) or TX (for Texas evacuees from Hurricane Rita).
b. In the Date field beside the Individual Special Use code, enter the first and last month of the certification period. For example, an application taken in October for MIC with October eligibility would have dates entered 102005092006.
IV. AID/PROGRAM CATEGORIES
A. The following programs are exempt from this policy:
1. Special Assistance
2. Refugee Assistance Program
For questions regarding refugees, asylees, etc., contact the Division of Social Services, Refugee Services at 919-733-4650 for guidance.
3. Work First
B. Health Choice
1. Hurricane Katrina Evacuees
Approve applicants eligible for NCHC for one year and complete a review in their fourth month of assistance. Terminate individuals effective the fifth month of assistance if they do not meet eligibility requirements in North Carolina.
Enter a special review code or flag NCHC cases in order to review their eligibility before the end of their final month of assistance.
2. Hurricane Rita Evacuees
Approve applicants eligible for NCHC for one year. Since the re-enrollment process for NCHC is automated, EIS will automatically send a re-enrollment notice and application to each recipient during the first week of the 11th month of the current enrollment period. Refer to automated redetermination/re-enrollment procedures in MA-3420, Re-Enrollment.
C. SSI Recipients
Verify SSI recipients through SOLQ and approve as non-SSI following
procedures in I., II. and III. above.
D. MQB-B and MQB-E
Recipients who have their Medicare premium paid by another state are not
eligible for MQB-B or MQB-E. However, due to eligibility differences between
states, the applicant may be eligible for full Medicaid in North Carolina.
V. EFFECTIVE DATE
This policy is effective October 1, 2005.
Should you encounter situations in which you need additional guidance, please contact your Medicaid Program Representative.
L. Allen Dobson, Jr., M.D., Assistant Secretary
For Health Policy and Medical Assistance
(This material was researched and written by Miranda K. Foggie, Policy Consultant, Medicaid Eligibility Unit, and Susan Ryan, Policy Project Manager, Medicaid Eligibility Unit.)