DATE: JANUARY 29, 2001
Manual: Family’s and Children’s Medicaid
To: County Directors of Social Services
Effective: February 1, 2001
Despite enormous progress in expanding Medicaid and NC Health Choice to eligible low income families, some individuals continue to lose Medicaid. Continuing Medicaid for eligible families is a top priority at the federal and state level.
The Health Care Financing Administration has issued guidance for conducting an evaluation when an individual is determined ineligible for Medicaid in any aid program/category. An ex parte review must be conducted on these terminations.
The ex parte procedures have been expanded to require that Medicaid evaluations for ongoing eligibility rely whenever possible on information already available to the agency. “Available to the agency” includes on line sources such as SDX or ESC and other programs’ records. Expanding sources of acceptable information will ensure that all possible avenues of continuing Medicaid eligibility are explored when terminating Medicaid.
Apply to all Medicaid and Work First Terminations on or after February 1, 2001.
Remove MA-3355, pages 1-11.
Insert MA-3355, pages 1-10, effective February 1, 2001.
Insert figures 1-5.
Please refer questions to your Medicaid Program Representative.
Paul R. Perruzzi
[This policy material was researched and written by Dora Boissy, Policy Consultant, Medicaid Eligibility Unit.]
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.