Family and Children's Medicaid Admin. Letters

DMA ADMINISTRATIVE LETTER NO: 09-13, RESIDENCY FOR ADOPTIVE CHILDREN MEDICAID

DATE: October 31, 2013

SUBJECT: Residency for Adoptive Children Medicaid

DISTRIBUTION: County Directors of Social Services

Medicaid Eligibility Staff

Effective November 1, 2013

I. background

In an effort to remove barriers and ensure continuation of services for adoptive children, the Medicaid County of residence is now the county where the beneficiary resides. This policy change insures beneficiaries receive services without delay and providers receive payment for services rendered.

This change does not impact adoption placement responsibility or payment of subsidy. The county of responsibility remains the same for these functions.

This change also does not apply to children in foster care or in the custody of DSS.

II. Determining county of residence

The county of residence for an adopted child is the county in which the child resides. This applies to children whether State Adoption or IV-E.

A. Apply this policy to applications processed on or after November 1, 2013.

B. Apply this policy to re-determinations/reviews processed on or after November 1, 2013.

C. Apply this policy to change in situation processed on or after November 1, 2013. County of residence should be changed if/when the parent or caretaker reports a problem with Medicaid services.

D. Coordinate with the Social Security Administration to have county of residence changed for SSI adopted children.

III. County Reassignment

When an adopted beneficiary in an ongoing case moves from one county to another, Medicaid eligibility must continue without a break in coverage. Upon notice of a physical move from one county to another:

A. Application:

1. Do not transfer a pending application to another county.

2. Once an application is approved, transfer the ongoing case according to procedures below.

B. Ongoing Case:

1. Check the certification period:

a. If re-enrollment is due, complete the re-enrollment and reassign the case to new county.

b. If re-enrollment is not due, key a county transfer:

(1) EIS

The effective date of the county transfer may be no earlier than the second month following completion and mailing of the transfer letter. At a minimum, the first county will continue assistance for one month following the keying of the transfer.

(2) NCFAST

The effective date of the county transfer is the first day of the month following the submission of the county transfer in NCFAST. Instructions for completing county transfer can be found in FAST Help procedures 1.1, Completing Case Transfers.

If you have any questions regarding this information, please contact a Medicaid Program Representative.

Sandra Terrell, MS, RN

Acting Director

ST/pc

(This material was researched and written by Pam Cooper, Policy Consultant, Medicaid Eligibility Unit).