MEMORANDUM

DATE:          October 2, 2006

TO:                All Aged, Disabled and Long Term Care Medicaid Manual Holders

FROM:          Policy and Program Development Team

                       Carolyn Spalding, Acting Chief

SUBJECT:  Aged, Disabled and Long Term Care Medicaid Manual Change #4

This manual change incorporates Medicaid policy that requires United States citizens to provide verification of their U.S.United States citizenship and identity.  This requirement is due to a change in federal law under the Deficit Reduction Act of 2005.  The policy changes were previously implemented by broadcast announcements.  Implementation in Alaska began on August 1, 2006 for Medicaid applications and renewals received on or after that date.

Note:  

The new law does not change the eligibility or verification rules that apply to non-citizens.  Qualified aliens are still required to provide verification of their status when they apply for Medicaid benefits.

Following is the guidance provided to implement the new requirement for applications and renewals received on or after August 1, 2006:

Application Processing:

Applicants for Medicaid who declare they are U.S.United States citizens are asked to provide proof of their citizenship and identity.  If the proof is not provided with the application, and the individual is a previous recipient, the caseworker will check the case file to see if the required documents have already been provided.  If the verification is not in the file, the application will be pended and notice M307 will be sent requesting the verification.  Applicants may be allowed additional time beyond the normal processing time frames if needed due to reasons beyond their control.  Applicants may not be found eligible for Medicaid until the necessary verification is provided.  

If the household does not provide the necessary proof or does not respond by the date requested, the application must be denied using the M205 notice and entering the ”CI” denial reason code in EISEligibility Information System .  

Note:

Coverage for Medicaid is denied only for the individuals who do not provide the requested citizenship and identity verification as required.

Renewal Processing:

As reviews are submitted, caseworkers will check the existing case file for proof of citizenship and identity for Medicaid recipients.  If the required documents are not in the file, send the M308 notice requesting the needed verification.  If necessary, recipients will remain eligible for Medicaid into the next month to allow time for them to respond to the request.  Recipients who provide the requested verification, or state they are trying to get the verification but are unable to provide it at this time, may be found eligible for a new review period.   In this situation, documentation will be required at the next redetermination.  A new eligibility period must be determined before a child is allowed the 6-month period of continuous eligibility.

If the household does not provide the necessary proof or does not respond by the date requested, the case will be closed with timely adverse action using the M 405 notice, and entering the ”CI” closure reason code in EISEligibility Information System .  

Note:  

Coverage for Medicaid ends only for the individuals who do not provide the requested citizenship and identity verification as required.

In an effort to comply with the federal law, and make the process as easy as possible for applicants, recipients, and staff, we have:

• Created flyers about the new Medicaid citizenship and identity verification requirements, and sent a supply of these to offices and other interested parties to hand out with applications.
   

• Created new EISEligibility Information System codes for tracking the level of citizenship and identity verification provided as required by federal regulations.  
   

• Successfully matched over 60,000 Alaska residents with Bureau of Vital Statistics ( BVS ) data to verify citizenship.  We are continuing to pursue future automated BVSBureau of Vital Statistics matches.
   

• Developed new Medicaid EISEligibility Information System notices for requesting citizenship and identity verification, and for denying or ending eligibility for an individual who does not provide verification.  

This manual change also includes other policy clarifications and updates which are described below.   

If you have any questions, please contact any member the Policy and Program Development Team at 465-3347 or email dpapolicy@health.state.ak.us.

OVERVIEW OF CHANGES

506 - Medicare Buy-In

Adds instructions to send EISEligibility Information System notice ”M710 - Medicare Drug Coverage Begins” when a Medicaid applicant has Medicare, and when a recipient becomes eligible for Medicare.

514 - Residents of Institutions

Adds exception to policy for an individual age 65 and older who resides in an inpatient psychiatric hospital.  Also removed ”Emergency Placement” section, as it is now included under ”Exceptions”.

520 - Eligibility Requirements that Follow APAAdult Public Assistance Policy

• Adds Medicaid exception to APAAdult Public Assistance policy on requirement to provide verification of U.S.United States citizenship and identity.

• Adds subsection on Loss of Contact.

• Adds subsection on Age.

523 - Medicaid Exceptions to APAAdult Public Assistance Policy

Adds clarification that APAAdult Public Assistance policy for in-kind support and maintenance does not apply to eligibility for the Special Long Term Care category.

575 - Breast and Cervical Cancer Medicaid

Updates contact information for the Breast and Cervical Cancer Coordinator.

580 - Medicare Premium Assistance Categories

• Updates SLMBSpecified Low Income Medicare Beneficiaries and SLMBSpecified Low Income Medicare Beneficiaries Plus categories with information on Medicare Part D.

• Removes instructions to contact DPADivision of Public Assistance Policy and DMA Third Party Liability Unit ( TPL ) when authorizing a SLMBSpecified Low Income Medicare Beneficiaries Plus case.

• Includes a new eligibility code ”78” for use on the MEREMedical Reference screen when authorizing a SLMBSpecified Low Income Medicare Beneficiaries Plus case.   This instruction was distributed by broadcast on February 17, 2006.

Addendum 1 - Program Standards

Updates the Annual Federal Poverty Guidelines for Alaska effective April 1, 2006, and the Pickle Amendment Table.

MANUAL CHANGE FILING INSTRUCTIONS