Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.98-020 - Medical Services Policy Manual: MS 98-2 - Medicaid for Qualifying Individuals

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 the Refugee Resettlement
			 Program;
33.
Women
			 found eligible for Family Planning Waiver services and whose benefits are
			 limited to family planning services only. Re. MS 5900;
34.
Individuals found eligible for
			 Transitional Employment Assistance related Medicaid. Re. MS
			 2085;
35.
A Qualifying
			 Individual - 1 whose income is at least 120% but less than 135% of the Federal
			 Poverty Level and who meets all other requirements for the category will be
			 eligible for payment of the Medicare Part B premium. Re. MS 2073;
			 and
36.
A Qualifying
			 Individual - 2 whose income is at least 135% but less than 175% of the Federal
			 Poverty Level and who meets all other requirements for the category will have a
			 portion of the Medicare Part B premium paid. Re. MS 2074.
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), QDWI (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 (SSI) 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 (01S)*-0IS 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., SSI 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-3911, 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, Mailing Address, Zip
						  Code
Unearned Income Amount
SSI Living Arrangement
Unearned Income Frequency;
Date of Death (month, year)
Unearned Income CIaim/ID Number
Marital Status
Earned Income Peritid
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 County
				Office Worker requesting the change. Supporting documentation will be submitted
				if available.
The county officer worker 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
				Recipient" printout that needs correction,