Adult Medicaid Change Notices

A. The requirement to pend applications for three months ended.

B. Penalty checks are no longer issued.

C. DDS is no longer required to pend applications.

D. The requirement to complete an interview unless the client arrives at the agency within 30 minutes of closing changed to 60 minutes.

E. The requirement to send out two requests for information 10 calendar days apart changed to sending out two requests for information 12 calendar days apart. (The 10-10 rule became the 12-12 rule.)

A. MA-2301, Application Processing, Intake Interview, has been rewritten and renamed MA-2301, Conducting A Face-To-Face Intake Interview.

B. DMA Administrative Letters

CHANGE NOTICE FOR MANUAL, NO. 06-03, Application Processing, MA-2301, Conducting a Face-to-Face Intake Interview

DATE: AUGUST 12, 2002

Manual: Aged, Blind, and Disabled Medicaid MA-2301

Change No: 06-03

To: County Directors of Social Services

Effective: October 1, 2002

I. BACKGROUND

On February 5, 2002, Judge Graham C. Mullen, Chief Judge, U.S. District Court for the Western District of North Carolina, dismissed the Alexander Consent Order. The February 1992 version of the Consent Order required payment of penalties or remedial fines if the counties did not process applications according to federal regulations and State rules.

Judge Mullen approved a “Plan to Assure Timely and Quality Services to Applicants for Medicaid, otherwise known as the Exit Plan”. The Centers for Medicare and Medicaid Services and Legal Services had approved this Exit Plan. The State had worked with a group of county representatives in developing this plan.

The persons from the following counties who worked on this plan were:

Brenda Davis of Catawba County

Millie Brown and Elva Quinn of Duplin County

Dave Bradshaw and Dale Moorefield of Forsyth County

Betty Barnes of Johnston County

Jean Biggs and Vicki Lewis of Martin County

Sarah Bradshaw and Alvinia Parker of Sampson County

While this Exit Plan does not change all that the counties might have wanted, it did result in the dismissal of the Consent Order. The Exit Plan reflects the commitment of both the State and the counties to continue to provide accurate benefits to our citizens in a timely manner. Each county in the State deserves recognition for its efforts. It is critical that counties continue to provide accurate benefits in a timely manner.

While Work First (WF) applications are not under the Exit Plan, a Work First application is considered an application for Medicaid. If a person comes to the agency to ask for financial assistance, he must be given the opportunity to apply for Medicaid that same day. This applies even if the county requires the person to go to the Employment Security Commission or to the Child Support Enforcement office before taking a WF application.

Due to changes needed in the Eligibility Information System, all aspects of the Exit Plan could not be implemented until EIS was ready. In DMA Administrative Letter No. 19-02, some policy changes were made without EIS support. They were:

A. The requirement to pend applications for three months ended.

B. Penalty checks are no longer issued.

C. DDS is no longer required to pend applications.

D. The requirement to complete an interview unless the client arrives at the agency within 30 minutes of closing changed to 60 minutes.

E. The requirement to send out two requests for information 10 calendar days apart changed to sending out two requests for information 12 calendar days apart. (The 10-10 rule became the 12-12 rule.)

As a result of enhancement to EIS, all of the aspects of the Exit Plan can now be implemented.

II. content of change

A. MA-2301, Application Processing, Intake Interview, has been rewritten and renamed MA-2301, Conducting A Face-To-Face Intake Interview.

1. This section contains instructions the agency must follow when conducting a face-to-face interview. The applicant’s rights and responsibilities, general Medicaid eligibility requirements and available Medicaid services are explained in this section.

2. The DMA-5096, Documentation of Need, a tool for documenting the applicant’s responses to basic eligibility requirements and for evaluating eligibility under all possible coverage groups, has been added to MA-2301.

B. DMA Administrative Letters

This policy change obsoletes the following DMA Administrative Letters.

III. EFFECTIVE DATE

This policy change is effective October 1, 2002.

IV. IMPLEMENTATION PROCEDURES

Apply these changes to any applications taken on or after October 1, 2002. For applications dated prior to October 1, 2002, follow the policies and procedures in effect prior to October 1, 2002.

V. MAINTENANCE OF MANUAL

Remove: MA-2301, Application Processing, Intake Interview

Insert: MA-2301, Conducting A Face-To-Face Intake Interview and Figures 1, 2, and 3.

Online Manual: Entire Section Revised with hyperlinks to forms.

If you have any questions regarding this material, please contact your Medicaid Program Representative.

Nina Yeager

Director

(This policy was researched and written by Vanessa Broadhurst, Policy Consultant, Medicaid Eligibility Unit.)

MA-2301

MA-2301, Fig. 1, DMA-5096

MA-2302, Fig. 2, DSS-8168-1

MA-2301, Fig. 3, DMA-2069