DATE: December 18, 2002
SUBJECT: MQB-E/Qualifying Individuals (QI1) Program Changes For January 2003
DISTRIBUTION: County Directors of Social Services
Medicaid Eligibility Staff
The Balanced Budget Act of 1997 established a mandatory eligibility group of low income Medicare beneficiaries. The funding for this group, the Qualifying Individuals (QI1/MQB-E), was based on a fixed allocation at 100% Federal Financial Participation (ffp) through December 2002.
President George W. Bush signed a continuing resolution to extend funding of the QI1 program at its present funding level through January 2003. QI2 did not receive funding. Congress is still in session and may take action to continue funding the QI1 program past January 2003, but what action will be taken is unknown at this time.
The purpose of this letter is to notify you that beginning 1/1/2003, do not take MQB-E applications, transfer cases to MQB-E, change the Medicaid Classification to MQB-E, or complete redeterminations on any MQB-E cases. You are required to track these individuals in case the MQB-E program is continued. This letter also outlines procedures for extending eligibility for existing MQB-E cases through January 31, 2003. There will be a subsequent administrative letter regarding what will happen next with the MQB-E program.
REMINDER: Do not take applications or transfer individuals to the QI2 program after 12/31/2002. QI2 funding expires 12/31/2002. (See DMA Administrative Letter No. 11-03, Addendum 1 dated November 19, 2002 for information about the termination of the QI2 program.)
Key all 8124s for MQB-E applications taken prior to 1/1/2003 by the end of the day on 12/31/2002. The QI indicator on the 8124 will be disabled effective 1/1/2003 and you will no longer be able to register MQB-E applications.
Beginning 1/1/2003, do not take MQB-E applications. You must keep a list of individuals for whom you would have taken a MQB-E application. This is required so the individuals may be contacted about an application if funding is restored to the program. Use the attached tracking sheet to list all the individuals affected by this change. Maintain one tracking sheet in your county that includes potential MQB-E applicants and individuals who would have been transferred to MQB-E but were terminated due to this change in policy.
Dispositions for MQB-E applications taken prior to 1/1/2003 need to be keyed and processed in EIS prior to 1/1/2003. If they are not, you must key the approval on the DSS-8125 and contact a consultant in the EIS unit at DMA at (919) 857-4019 with the DSS-8125 form number and request the form be processed in order to authorize eligibility prior to 1/1/2003. For MQB-E approvals, enter the Medicaid certification through date as January 31, 2003 unless the 8125 is approved with a termination date prior to 1/31/2003 (open/shut).
Beginning January 1, 2003, do not transfer a case to MQB-E or change the Medicaid Classification to MQB-E until further notice. If the individual is eligible for in a Medicaid program other than MQB-E, transfer the case to that program. If he is not eligible in a program other than MQB-E, terminate the case.
Beginning January 1, 2003, keep a list of individuals who would have transferred to MQB-E. This is required so the individuals may be contacted about an application if funding is restored to the program. Use the attached tracking sheet to list all the individuals affected by this change. Maintain one tracking sheet in your county that includes potential MQB-E applicants and individuals who would have been transferred to MQB-E but were terminated due to this change in policy.
EIS automatically will extend the certification through date for MQB-E cases to January 31, 2003. We anticipate this update occurring the night of January 6, 2003. A list of the cases that are updated will be available the next day in a report on XPTR. The report name will be “DHREJ QI1 Cert Ext Thru 1/31/03”. We will confirm by terminal message on January 6, 2003, if the update will occur that night.
MQB-E cases with an 8125 pending the day the certification period extension runs will not be included in the automatic update. Also, MQB-E cases that do not have a certification through date of 12/31/2002 will not be updated. These cases will require manual update of the certification period if the case remains active MQB-E. DMA will notify counties of cases requiring manual updates.
If you have questions, please contact your Medicaid Program Representative.
Nina M. Yeager
[This material was researched and prepared by Mary Spivey, EIS Consultant, Medicaid Eligibility Unit.]
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.