DATE: December 31, 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. A second continuing resolution subsequently was signed to extend funding through March 2003. QI2 still did not receive funding. Congress may take action to continue funding the QI1 program past March 2003, but what action will be taken is unknown at this time.
The purpose of this letter is to notify you that beginning January 7, 2003, authorize eligibility through March 31, 2003 for MQB-E approvals of applications taken prior to January 1, 2003, if the person continues to be eligible for MQB-E. The night of January 6, 2003, eligibility in EIS for existing MQB-E cases is being extended automatically through March 31, 2003. Follow these instructions until you receive 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.)
As stated in DMA Administrative Letter 14-03, Addendum 1 dated December 18, 2002, 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.
For approvals of MQB-E applications taken prior to 1/1/2003, 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 the eligibility prior to 1/1/2003. Enter the Medicaid certification through date as March 31, 2003 unless the 8125 is approved with a termination date prior to 3/31/2003 (open/shut).
EIS automatically will extend the certification through date for MQB-E cases to March 31, 2003. This update will occur 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 3/31/03”.
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 or 1/31/2003 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.