A. MA-3215, Processing The Application, has been reissued to provide clarification to deny applications when the applicant refuses to assign his own rights or those of any other individual for whom he can legally make an assignment or he refuses to cooperate in identifying and providing TPR information.
B. MA-3510, Third Party Recovery (TPR), has been reissued to provide instructions for terminations or denials of cases that are out of compliance with the rules of Third Party Recovery. Individuals who fail to meet the assignment of rights provisions including assignment of rights to medical support or other third party resources shall be terminated or denied from receiving Medicaid due to non-compliance.
DATE: APRIL 1, 2005
Manual: Family And Children’s Medicaid
Change No: 15-05
To: County Directors of Social Services
Effective: May 1, 2005
Clarification for the beginning and ending dates of excluding processing days has also been provided. The exclusion of days cannot begin any earlier than the day the individual is notified of the last piece of information needed to process the application using the DMA-5098/DMA-5098S, Your Application for Medicaid is Pending. The “end date” for excluding processing days is the date that the Disability Determination Section (DDS) releases the case on the Disability Determination (DD) screen.
Clarification of the calendar days for a request to reopen a Medicaid/NCHC case has been provided. If the 10th calendar day falls on a non-workday, allow the individual until the next workday to request his case be reopened.
A revision has also been made to the age requirement for the Adult Helpless Child Allowance. To be eligible for the Adult Helpless Child Allowance, a child of a veteran must have been determined disabled prior to age 18.
Family and Children’s Medicaid Manual
Change Notice 15-05
This policy is effective May 1, 2005. Apply this policy to applications taken on or after May 1 and to re-determinations scheduled on or after May 1.
If you have any questions, please contact your Medicaid Program Representative.
(This material was researched and written by Sandi Morrow, Medicaid Policy Consultant II, Medicaid Eligibility Unit.)
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.