Adult Medicaid Change Notices
MA-2900, Recipient Fraud and Abuse Policy revisions include:
A. Requirement to send a request to the DMA Recipient Investigations Coordinator to release tax intercepts, make key changes to the debtor detail screen and the appeal indicator field in XII.D.5, XV.E, and F.3.
B. The name of the DMA-7063 has been changed to Medicaid/NCHC Recipient Profile throughout the policy.
C. An update to the address and phone number for the Office of Administrative Hearings (OAH) in XV.E.1.b.(2).
D. Adding to VI.B, the requirement for the county to enter a pending referral into EPICS within 7 days of the date of the referral for Quality Assurance referrals.
E. An updates to the income, reserve and Medicare tables.
This policy clarification is effective March 1, 2011.
A. Remove: MA-2900, Recipient Fraud and Abuse Policy and Procedures, pages 11-12, 17-20, 23-26, 29-40, 49-50, 57-58, 63-64, 69-80, Attachments 2a, 2b, and 3a.
B. Insert: MA-2900, Recipient Fraud and Abuse Policy and Procedures, pages 11-12, 17-20, 23-26, 29-40, 49-50, 57-58, 63-64, 69-80, Attachments 2a, 2b, and 3a effective 3/01/11.
CHANGE NOTICE FOR MANUAL NO. 05-11, RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES
DATE: FEBRUARY 25, 2011
Manual: Aged, Blind, and Disabled Medicaid
Change No: 05-11
To: County Directors of Social Services
Program Integrity Supervisors and Staff
Medicaid Supervisors and Caseworkers
Effective: March 1, 2011
I. Background
MA-2900, Recipient Fraud and Abuse Policies and Procedures, provides policy regarding how to establish overpayments in the Adult Medicaid program. This change notice revises the instructions for releasing of tax intercepts and changes to the debtor detail screen and appeal indicator field; the renaming of the DMA-7063, and updates the income, reserve and Medicare tables.
II. CONTENT OF CHANGE
MA-2900, Recipient Fraud and Abuse Policy revisions include:
A. Requirement to send a request to the DMA Recipient Investigations Coordinator to release tax intercepts, make key changes to the debtor detail screen and the appeal indicator field in XII.D.5, XV.E, and F.3.
B. The name of the DMA-7063 has been changed to Medicaid/NCHC Recipient Profile throughout the policy.
C. An update to the address and phone number for the Office of Administrative Hearings (OAH) in XV.E.1.b.(2).
D. Adding to VI.B, the requirement for the county to enter a pending referral into EPICS within 7 days of the date of the referral for Quality Assurance referrals.
E. An updates to the income, reserve and Medicare tables.
III. EFFECTIVE DATE AND IMPLEMENTATION
This policy clarification is effective March 1, 2011.
IV. MAINTENANCE OF MANUAL
A. Remove: MA-2900, Recipient Fraud and Abuse Policy and Procedures, pages 11-12, 17-20, 23-26, 29-40, 49-50, 57-58, 63-64, 69-80, Attachments 2a, 2b, and 3a.
B. Insert: MA-2900, Recipient Fraud and Abuse Policy and Procedures, pages 11-12, 17-20, 23-26, 29-40, 49-50, 57-58, 63-64, 69-80, Attachments 2a, 2b, and 3a effective 3/01/11.
If you have questions about this policy, please contact your county’s Medicaid Program Representative or the Quality Assurance Section at (919) 647-8000.
Craigan L. Gray, MD, MBA, JD
Director
(This material was researched and written by Angela Saddler, Recipient Investigations Coordinator, Quality Assurance Section)
