A. MA- 3420: Re-enrollment packets are no longer mailed to MIC and NCHC recipients for re-determinations of eligibility. References to the automated re-enrollment procedures for MIC/ NCHC have been removed.
C. MA- 3420. III.A. 2: An ex parte review for re-determinations of eligibility for both MIC and NCHC programs for children under the age of 19 will be utilized. This will require careful management of the Medicaid caseload and the case worker must be proactive in assisting the client through the process.
11th month of the certification period, unless the assistance unit was ineligible based on income verified in the ex parte process. This change will be included in MA-3300, Income, in a separate change notice.
F. MA- 3420 VIII.B.3 and IX.C.1: Have been updated to reflect changes from Administrative Letter 03-11 to authorize NCHC cases for an additional month when the timely notice period will not expire before cut-off.
A. The last automated MIC/NCHC re-determination packets were mailed on June 1, 2011 for reviews due July, 2011. The recipients must return these re-enrollment forms by June 25. Follow current automated re-enrollment procedures for these reviews.
DATE: JUNE 15, 2011
Manual: Family and Children’s Medicaid
Change No: 12-11
To: County Directors of Social Services
Effective: July 1, 2011
Administrative letter 03-11 provided information and instructions to Medicaid and NC Health Choice workers and supervisors regarding the end of the code 80 terminations for Medicaid for Infants and Children (MIC) and North Carolina Health Choice (NCHC) cases effective April 2011.
The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA or Public Law 111-3) includes many provisions that gives states the tools needed to effectively enroll eligible children in Medicaid and Children’s Health Insurance Program (CHIP) coverage. Section 203 of CHIPRA provides avenues to ensure that children eligible for Medicaid and CHIP have a fast and simplified re-enrollment process.
The North Carolina Division of Medical Assistance (DMA) will discontinue the automatic mailing of re-determinations for MIC and NCHC cases. The case worker will use the Case Management Report to identify MIC/NCHC cases due for re-determination.
The recipient will no longer receive a postcard (DMA-5067) to alert them that a review packet will be mailed. However, the DMA-5067/ DMA-5067S is revised, renamed the Re-Enrollment Information Notice and will be mailed to the recipient on the 15th day of the 10th month of the certification period. The notice explains it is time for a review and re-enrollment forms are no longer required. The DMA-5067 will explain the importance of reporting changes, types of changes to report and how to report any changes. Changes must be reported by the first day of the following month.
This policy is effective July 01, 2011. Apply this policy to MIC/NCHC redeterminations with a certification period ending August 31, 2011 or later.
This change will impact other sections of the F&C Manual. A separate change notice will be issued for the manual sections affected by this change.
If you have any questions, please contact your Medicaid Program Representative.
Craigan L. Gray, MD, MBA, JD, Director
(This material was researched and written by Susan Castle, Policy Consultant, Medicaid Eligibility Unit.)
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.