DATE: December 20, 2001
Manual: Family and Children’s Medicaid
Change No: 12-02
To: County Directors of Social Services
Effective: January 1, 2002
In August 2000, each county was sent a list of SSI terminated children with protected Medicaid status, along with instructions to identify and track each of these children until protected status ends. Protected status children could receive in any aid program/ category as long as their protected status was tracked.
The Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), now requires that children with protected Medicaid status must be authorized in the MAD-N category if they meet all other non-disability eligibility requirements for that category.
If a protected status child is ineligible for MAD-N, he may be authorized in a Family & Children's Medicaid category. However, you must determine eligibility for MAD-N at each review (and change in situation for MAF). If the child meets the eligibility criteria for MAD-N, authorize as MAD-N. The exception is for protected status children who are eligible for Work First Family Assistance. They must continue in the WFFA case. If WFFA eligibility ends, evaluate the child for MAD-N first. If he is ineligible for MAD-N, evaluate for other aid program/categories.
In all cases, continue to track protected status on the tracking sheet in the child's case record. Document the child's status at every review or evaluation for coverage. A child with protected Medicaid status must have a disability review at age 18 to determine if he meets adult disability criteria, regardless of the aid program/category of coverage.
MA-3200, Eligibility Regulations, is revised to add eligibility requirements for Children Under 18 With Protected Medicaid Status. MA-3355, Terminations/Deletions, is updated to include evaluations for MAD-N and for the new coverage group for Breast and Cervical Cancer Medicaid.
Apply these changes to applications in process on January 1 or taken on or after January 1, 2002, including applications for retroactive coverage.
B. Redeterminations/Change In Situation
At the next redetermination (or change in situation for MAF) after January 1, 2002, determine the child's eligibility for MAD-N.
For Work First terminations effective December 31, 2001, or later, you must evaluate the protected status child for MAD-N. Only if he is ineligible for MAD-N do you evaluate eligibility for other aid program/categories.
III. MAINTENANCE OF MANUAL
Remove: MA-3200, page 5
Insert: MA-3200, pages 5-6, revised 1/1/02
Online: Added new item VII.
Remove: MA-3355, pages 11-12
Insert: MA-3355, pages 11-12a, revised 1/1/02
Online: Revised items: III.D.1.a.(6) through III.D.5.b.(2)
If you have any questions regarding this information, please contact your Medicaid Program Representative.
Nina M. Yeager
[This material was researched and written by Jackie Franklin, Policy Consultant, Medicaid Eligibility Unit.]
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.