Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 28 - Division of County Operations › Rule 016.28.20-005 - Medical Services Policy Manual Sections B-700 through B-730 Transitional Medicaid

Current through Register Vol. 49, No. 6, June, 2024
Medical Services Policy Manual, Section B
B-700 Transitional Medicaid
B-700 Transitional Medicaid
MS Manual 12/01/20
The Family Support Act of 1988 ( Public Law 100-485 ), requires
				that certain Aid to Families with Dependent Children (AFDC) families (Category
				20) who lost eligibility April 1, 1990, or later, due to earned income must be
				given six (6) months of Initial Transitional Medicaid (TM) benefits without an
				application for such assistance. These families may also qualify for an
				Additional 6 Months Transitional Medicaid Extension.
The Personal Responsibility and Work Opportunity Reconciliation
				Act of 1996 extended this requirement to certain Medicaid families following
				replacement of the AFDC program with the Temporary Assistance for Needy
				Families (TANF) program. In Arkansas, families who lost eligibility for
				Parents/Caretaker Relatives (PCR), formerly TEA Medicaid, due to earnings are
				eligible for this extension.
The Patient Protection and Affordable Care Act of 2010 and the
				Health Care and Education Reconciliation Act of 2010 (collectively referred to
				as the Affordable Care Act) extended this requirement to certain Medicaid
				families following replacement of the TEA Medicaid program with the
				Parents/Caretaker Relatives Medicaid (PCR) program.
B-705 Extent of Services
MS Manual 12/01/20
Individuals approved for Transitional Medicaid will be eligible
				for the full range of Medicaid services, including services under the
				Children's Health Services Program.
B-710 Eligibility Requirements
MS Manual 12/01/20
In addition to the standard Medicaid eligibility requirements
				of citizenship, enumeration and child support enforcement, the following
				requirements must be met in determining eligibility for the Initial 6 Months TM
				Extension Period:
1. The family must
			 have become ineligible for PCR Medicaid due to increased wages or increased
			 hours of employment.
2. The family
			 must have received PCR Medicaid in at least 3 of the 6 months immediately
			 preceding the first month of PCR Medicaid ineligibility. Retroactive months
			 count for this purpose.
3. The
			 family members must have been residents of Arkansas in the last month of PCR
			 Medicaid eligibility and must continue to reside in Arkansas.
4. There must be a dependent child under age
			 18 in the home.
In addition to the eligibility criteria stated above, the
				following eligibility requirements must also be met in the Additional 6 Months
				TM Extension Period:
5. The
			 family must have received TM in each month of the Initial 6 Months TM Extension
			 Period.
6. There must continue to
			 be a dependent child under age 18 in the home.
7. The parent (or non-parent specified
			 relative) must have met the reporting requirements in the 1st and 4th months of
			 the Additional TM Extension Period (Re: MS B-735 and MS B-750).
8. The parent or (non-parent specified
			 relative) must continue to be employed and receive earnings in each month
			 preceding the 2nd and 3rd
			 report periods of the Additional TM Extension Period, unless good cause exists.
The average monthly gross earnings of the eligible members
				cannot exceed 185% of the Federal Poverty Level (Re.
FPL Chart at
				Appendix F
).
Resources, deprivation, and unearned income are not eligibility
				factors for TM.