DATE: September 14, 2001
Manual: Family and Children’s Medicaid
Change No: 07-02
To: County Directors of Social Services
Effective: October 1, 2001 Make the following changes:
The Centers for Medicare and Medicaid Services (CMA), formerly known as HCFA, issued guidance to ensure that eligible families continue to receive Medicaid benefits. Instructions regarding ex parte reviews were issued in an April 7, 2000 letter to the State. As a result of this letter, several changes to different policies have been issued. Now Ma-3356 will change to accommodate the requirements in the April 7th letter.
Currently, at the end of the four months transitional Medicaid period, EIS automatically terminates the Medicaid benefits. MA-3356, Four Months Transitional Medicaid, is revised to incorporate EIS modifications to no longer allow automatic terminations at the end of the four monthss transitional period. This ensures that all families are appropriately evaluated for all categories of Medicaid prior to termination of benefits.
Beginning with four months transitional Medicaid cases ending October 31, 2001, EIS will not automatically terminate at the end of the four months transitional period. EIS will automatically transfer the case to MAF-C for two months when the redetermination and program transfer have not been completed or the worker has not terminated the case by the Work First cut-off in the 4th month.
Example: A redetermination is completed on a four months transitional Medicaid Case. No assistance unit member is eligible under any aid program/category. The caseworker must document and propose termination using the appropriate reason code with a timely notice to end no later than the Work First cut-off in the 4th month. Otherwise the case will transfer to MAF-C for two months.
The transitional case can be terminated by the caseworker when: the redetermination is completed prior to the end of the transitional period; ineligibility for all Medicaid programs has been established and the appropriate notice has been sent in time to terminate at the end of the transitional period.
There is also a new report, entitled Transitional Cases Due Review. Four months transitional cases that are in the second month of the transitional period will appear on this report. A redetermination is needed on these cases prior to the end of the four months transitional period. The Transitional Cases Due Review report is available in XPTR and counties will also receive a paper copy. The report is listed in XPTR as “DHREJ TRANS CASES DUE Review.”
If a redetermination and program transfer are not completed or a case termination is not completed by Work First regular run, these cases will be transferred to MAF-C for two months. These cases will then display on the Case Management Report as review due.
This change is effective October 1, 2001 for four months transitional Medicaid cases whose 4th month is October 2001 or later.
Any transitional Medicaid Cases (pay type 4) that are in the 4th month of transitional in September 2001 and are not transferred to another aid program category prior to Work First regular run, will terminate the night of Work First regular run.
Follow the policy and procedures transmitted in this Change Notice for four month transitional Medicaid cases whose 4th month is October 2001 or later.
Remove MA-3356, pages 1-4.
Insert attached MA-3356, pages 1-5, effective October 1, 2001.
If you have any questions, please contact your Medicaid Program Representative.
Nina M. Yeager
[This material was researched and prepared by Cinnamon Narron, Policy Consultant, Medicaid Eligibility Unit.]
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.