Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.97-025 - Medical Services Policy Manual - Revised Policy

Current through Register Vol. 49, No. 6, June, 2024
At revaluation, all eligibility factors (including
				appropriateness of care and cost effectiveness) will be redetermined (Re. MS
				2090.1). Disability will be redetermined as specified in MS 2090.4. Completion
				of forms DCO-777, DCO-662, DCO-75, DCO-662, DCO-707, DC0-769, DC0-2602 and
				DCO-2603 is necessary at reevaluation. The DCO-87 must be coded for the next
				reevaluation, MRT reexamination, or any expected changes.
2094
Change/Closure
When a change occurs that affects eligibility, the county
				office worker will notify the TEFRA Committee when closure will be made. A copy
				of the DCO-700 used to notify the individual or a memorandum (when an DCO-55 is
				sent) will be used for the 0MS notification.
Ten day advance notice of closure via the DCO-700 or
				DC0-55 will be given, unless advance notice is not required (Re. MS.3633). Form
				DCO-57 will be completed for the close (C) action effective the date notice
				expires.
*
2095
Emergency Services for Aliens
Aliens who are not qualified aliens(as defined at MS 3310
				#3) are eligible
for
emergency
				services only if the following conditions are met.
1.
The alien has a medical condition
			 (including labor and delivery) manifesting itself by acute symptoms of
			 sufficient severity (including severe pain) such that the absence of immediate
			 medical attention could reasonably be expected to result in:
. Placing the patient's health in serious
				jeopardy,
. Serious impairment to bodily functions,
				or
. Serious dysfunction of any bodily organ or
				part.
2.
To be
			 eligible for emergency services, an alien meeting the medical criteria in
			 paragraph 1 also must meet all other eligibility requirements for Medicaid
			 (categorical, income, resources, etc.) as set forth in the State's approved
			 plan, with the exception of citizenship/alienage requirements, and Social
			 Security enumeration.
Verification and documentation of the emergency condition
				must be obtained through the attending physician's statement that the alien met
				the criteria in paragraph 2. In addition, the alien will provide other
				supporting documentation of the emergency that may include hospital and
				emergency room records, ambulance receipts, collateral statements, media
				reports, etc.
If certified in a family type Medicaid category, only the
				alien(s) with the emergency medical condition(s) may be entered in closed
				status for fixed eligibilty as an eligible member(s); all other citizen or
				qualified alien family members included in the budget will be entered in closed
				status with no medical eligibility.
NOTE: When determining eligibility for an adult, deem the
				income of a non-qualified alien spouse to the applicant, but do not include his
				or her needs in the need standard. A citizen or qualified alien spouse's income
				must be counted in full, with his or her needs included. The income and needs
				of non-qualified alien children will be disregarded. A citizen or qualified
				alien child's income and needs may be included if needed.
When determining eligibility for a child, deem the income of a
				nonqualified alien parent(s) to the applicant, but do not include needs of the
				parent(s) in the need standard. Income of a citizen or qualified alien
				parent(s) m"st be counted in full, with the needs
				included. The income and needs of non-qualified alien siblings will be
				disregarded. A citizen or qualified alien sibling's income and needs may be
				included if needed.
A period of eligibility will be granted only to cover the
				period of time in which the necessity for emergency services existed. The
				period of eligibility will be a fixed retroactive period, and Medicaid begin
				and end dates will be entered.
The certified alien(s) will be eligible for all medical
				services relating to the emergency, including
				transportation.