Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.98-004 - Emergency Promulgation - MS 98-2: Medicaid for Qualifying Individuals-1 (QI-1) and Qualifying Individuals-2 (QI-2); two new Medicaid groups

Current through Register Vol. 49, No. 6, June, 2024
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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;
t
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 659di
31.
Individuals eligible for the
			 Medically Needy Program. Re. fos ?#6#
32.
Refugees eligible for Medicaid
			 under "specif eligibility period" criteria of the Refugee Resettlement
			 Program;
33.
Women
			 found eligible for Family Planniri9 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 ntfets all
				other requirements for the category will be eligible for payment [LESS
				THAN][GREATER THAN]f 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
				°f
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 establisned
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 tne begin and end dates for these categories is
				found in the eligibility section
for
each
				category.
2010
Supplemental Security Income
(SSI)
EHqibles
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 (OIS). 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., 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 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 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,