Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.05-079 - DMS-2005-W-3: Medical Treatment for Hurricane Katrina Evacuees

Current through Register Vol. 49, No. 6, June, 2024
I. Introduction
Arkansas has requested and received approval from the Centers
				for Medicare and Medicaid Services (CMS) to implement a Medicaid waiver to
				enable the state to reimburse providers for services provided to Hurricane
				Katrina evacuees. The covered services are those available to Arkansas Medicaid
				beneficiaries who qualify for the full range of Medicaid services. These
				beneficiaries will receive Medicaid ID cards the same as any other
				beneficiaries.
The primary care physician (PCP) referral requirements are
				waived and do not apply to this population. All other Medicaid requirements are
				applied to this group, e.g. prior authorization, extension of benefits,
				co-payments, etc. Claims should be submitted as providers would submit for any
				other Medicaid beneficiaries.
NOTE: The information in this notice does not apply to
				persons who evacuated their homes solely as a result of Hurricane
				Rita.
II. Waiver Eligibility
			 Criteria
The term evacuee refers to an individual who is a resident of
				the counties/parishes declared as disaster areas as a result of damage
				inflicted by Hurricane Katrina, has no private health insurance and has income
				within the limits shown in this document.
The income limits for Medicaid coverage within the waiver
				are:
Children Under Age 19
up to and including 200% FPL
Pregnant Women from Louisiana, Mississippi and
						  Florida
up to and including 185% FPL
Pregnant Women from Alabama
up to and including 133% FPL
Individuals with Disabilities
up to and including 300% SSI
Low-income Medicare Recipients
up to and including 100% FPL
Low-income Individuals in need of Long Term Care
up to and including 300% SSI
Low-income Parents of Children Under Age 19
up to and including 100% FPL
Monthly Income limits per family size are:
Family Size
100%
133%
185%
200%
1
797.50
1060.68
1475.38
1595.00
2
1069.17
1422.00
1977.96
2138.34
3
1340.83
1783.30
2480.54
2681.66
4
1612.50
2144.63
2983.13
3225.00
5
1884.17
2505.95
3485.71
3768.34
6
2155.83
2867.25
3988.29
4311.66
7
2427.50
3228.58
4490.88
4855.00
8
2699.17
3589.90
4993.46
5398.34
9
2970.84
3951.22
5496.05
5941.68
10
3242.51
4312.54
5998.64
6485.02
For each additional member add:
271.67
361.32
502.59
543.34
Evacuees who appear to be eligible based on the criteria
				described in section II above, must be referred to the county Department of
				Health and Human Services office to file an application. Providers should
				collect the information normally documented for Medicaid beneficiaries for the
				patient's file. Patient files must support actions taken by the provider when
				reviewed during a federal audit.
III. Medicaid Application Process
The Department of Health and Human Services, Division of County
				Operations staff in the local state DHHS offices are responsible for taking and
				processing assistance applications. They have been instructed to expedite the
				process for this population so beneficiaries and providers have access to
				information regarding eligibility quickly.
Applications may be filed no later than January 31, 2006.
				Approvals will be for a five-month period beginning the date of eligibility.
				Retroactive eligibility may be approved, but the retroactive period will count
				as part of the five months.
Example 1: If an application is filed December 1, 2005 and the
				applicant alleges medical expenses beginning October 1, 2005, the five-month
				period will begin 10-1-05 and end February 28, 2006.
Example 2: If an application is filed January 31, 2006 for
				services beginning 1-31, the five-month period will begin January 31, 2006 and
				end June 30, 2006.
As with the regular Medicaid population, providers are
				encouraged to verify eligibility each time a service is provided. If the
				patient is not eligible at the time of the service, continue to access the EDS
				system to verify the eligibility period.
Claims should be filed as quickly as possible after the service
				is provided.
IV.
			 Uncompensated Care Pool
In addition to evacuees covered within the waiver, Arkansas is
				submitting a plan to cover evacuees who are not otherwise eligible for
				Medicaid, reside in a federally declared disaster area, have no comprehensive
				health insurance and have income that does not exceed an amount to be
				determined by CMS. Coverage for the uncompensated care group will be for one
				five-month period as determined by the state.
More information will be made available to providers when DMS
				receives approval of the uncompensated care plan. Another notice will be posted
				to DMS' web site at www.medicaid.state.ar.us. Providers should collect the
				information normally documented for Medicaid beneficiaries for the patient's
				file. Patient files must support actions taken by the provider when reviewed
				during a federal audit.
If you need this material in an alternative format, such as
				large print, please contact our Americans with Disabilities Act Coordinator at
				(501) 682-8365 (voice) or (501) 682-6789 (TDD).