Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.95-010 - Changes in Medical Services Policy Manual to Extend Medicaid Eligibility to Certain Recipients who have lost SSI Benefits

Current through Register Vol. 49, No. 6, June, 2024
27. Pregnant Women found presumptively
			 eligible by a Qualified Provider for ambulatory prenatal care. Re. MS
			 5600;
28. Individuals eligible for
			 the U-18 category. Re. MS 6000;
29.
			 Title IV-E and other Foster Children. Re. MS 6000 and 7000;
30. Non-Title IV-E Adoptive Children with
			 Special Needs, Re. MS 6590;
31.
			 Individuals eligible for the Medically Needy Program, Re. MS 7000;
32. Refugees eligible for Medicaid under
			 "special eligibility period" criteria of Refugee Resettlement Program;
			 and
33. Drug addicts and alcoholics
			 who lose their SSI, provided that they meet certain requirements. Re: MS 2055.
2005
Date Specific
			 Eligibility
With date specific eligibility, for most Medicaid categories an
				individual's or family's eligibility may begin or end on any day of a
				month.
When eligibility is established, eligibility will begin on the
				day the application was registered, unless retroactive coverage is needed. If
				retroactive coverage is needed and if eligibility is established for a
				retroactive period, eligibility can begin up to 3 months prior to the date of
				application (but not on the first day of the third retroactive month unless the
				application was filed on the first day of a month).
Eligibility for most Medicaid categories under date specific
				eligibility may be terminated at any time. The end date of eligibility will be
				the last day of the 10 day advance notice period, unless a recipient requests a
				hearing within the advance notice period,
There are some Medicaid categories in which eligibility may not
				begin or end on any day of a month. These categories are: QMB (MS 2047), SMB
				(MS 2051), QOWI (MS 2048), and TM (MS 2061), Information about the begin and
				end dates for these categories is found in the eligibility section for each
				category.
2010
Supplemental Security Income fSSI) Eligibles
Individuals who have been determined eligible for SSI benefits
				by the Social Security Administration (SSA) are eligible for Medicaid (i.e.,
				recipients of straight SSI benefits, Mandatory State Supplements, SSI
				conditional payments and SSI presumptive disability payments).
The County Office is notified of SSI eligibles by printout as
				SSA makes information available to the Office of Information Systems (CIS). OIS
				will mail Medicaid ID cards to all SSI eligibles at certification.
SSA will notify OIS via the State Data Exchange system of
				changes for this group of eligibles. The County Office will notify the local
				SSA District Offices by means of a lead form, RVI-302, regarding current
				changes reported by/for individuals within this group (e.g., SSl recipient
				enters a nursing home).
2010.1
National Correction
			 Procedure
The National Correction Procedure is a process for notifying
				the Social. Security Administration (SSA) of changes that could affect
				SSI/Medicaid eligibility and/or the amount of State supplementation
				payments.
When information is received that is not reflected on the
				latest "SSI Recipient" printout, the County Office will submit the information
				to SSA via the SSA-391i, Report of Change-SSI Data. The following information
				can be reported:
Recipient's Name
Resources
Sex
Unearned Income Type
Date of Birth
Unearned Income Stop Date
Payee Name, Hailing Address, Zip Code
Unearned Income Amount
SSI Living Arrangement
Unearned Income Frequency
Date of Death (month, year)
Unearned Income Claim/ID Number
Marital Status
Earned Income Period
Residence Address, Zip Code
Earned Income Wage Estimate
State, County of Jurisdiction
Net Self-Employment Income Estimate
In addition, the County Office will properly identify the
				recipient and/or any other individual, the reason for submittal, and the
				Service Representative requesting the change. Supporting documentation will be
				submitted if available.
The Service Representative will complete Parts I and II of the
				SSA-3911. Completion and routing are self-explanatory with the following
				exceptions: .
Item 8. - Enter Bureau of Supplemental Security Income, 1200
				Main Tower Bldg., Dallas, TX 75202,
Item 10. - Enter the information from the "SSI Recipients"
				printout that needs correction,
2051.6
Changes
A.
Disregard of SSA Cost of
			 Living Adjustment (COLA)
The SSA COLA increases which are received in January of each
				year will be disregarded for SRB applicants and recipients until the month
				after the new Federal Poverty Levels are issued to counties. The new FPLs are
				usually issued in March with an effective date of April 1st.
When Counties receive the new SMB income limits, effective
				April 1, the individual's income, including the January COLA increase, will be
				compared to the new SMB income limit to determine if eligibility will continue
				for April and later months.
If an individual or couple is ineligible due to the COLA
				increase, an EMS-700 will be sent as advance notice of closure, and case will
				be closed when the notice expires.
B.
Reevaluations
SMB reevaluations will be conducted annually. All eligibility
				factors will be redetermined. Completion of Forms EMS-777, EMS-707, and EMS-769
				are needed at each reevaluati on. Form EMS-662 wi 11 be completed, i f
				necessary.
C.
Closure
If a change occurs that affects eligibility, a ten day advance
				notice of closure will be issued via the EMS-700 or EMS-55, unless advance
				notice is not required (Re, MS 3633). Form EMS-57 will be completed for the
				closure effective the date that the notice expires. With date specific
				eligibility, eligibility will be terminated when the ten day notice period has
				ended, unless the recipient requests a hearing within the ten days.