Adult Medicaid Manual MA-1100 SSI MEDICAID-COUNTY DSS RESPONSIBILITY

X. NON-ELIGIBILITY RELATED MEDICAID PROCEDURES

A. Returned Cards

1. Undeliverable Medicaid cards will be returned to the county dss. It is recommended that the cards be filed in one place. If a recipient reports he did not receive his Medicaid card, research the file. The card can be given to him personally or mailed to him. Follow instructions in MA-2380, Medicaid Identification Card.

2. Advise the recipient that Medicaid cards are not forwarded. Instruct the individual to report any change in address to SSA to ensure the Medicaid address is corrected.

3. Retain returned ID cards for 3 months. If they have not been claimed they may be shredded. Refer to shredding instructions in MA-2380, Medicaid Identification Card.

B. Replacement Cards

If an SSI Medicaid recipient reports he lost his Medicaid card or did not receive it, the county dss can order a replacement Medicaid card. Follow procedures in MA-2380, Medicaid Identification Card, to issue the card.

C. Transportation Services

SSI Medicaid recipients are eligible for Medicaid transportation services. The Medicaid approval notice instructs the SSI recipient to contact the county dss if he needs transportation to medical care.

An SSI recipient may apply for transportation in person or by phone. When an SSI Medicaid recipient requests transportation assistance, follow instructions in MA-2910, Medicaid Transportation.

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(X.)

D. Community Care of North Carolina/Carolina Access (CCNC/CA)

SSI Medicaid recipients are required to participate in Community Care of North Carolina/Carolina Access (CCNC/CA) unless they also receive Medicare. CCNC/CA participation is optional for Medicare beneficiaries.

1. New SSI Medicaid recipients will have an exempt code automatically assigned by EIS. These exempt codes will be:

a. 9900010 for SSI Medicaid recipients who are required to participate in the program, or

b. 9900011 for SSI Medicaid recipients who have Medicare and for whom participation is optional.

2. The SSI Medicaid approval notice gives a brief explanation of CCNC/CA and instructions to contact the county dss within 30 days to choose a primary care provider.

3. When the recipient contacts the dss by phone or in person, an Income Maintenance Caseworker is responsible for providing program education and a list of participating primary care providers from which to make a choice. The State CCNC/CA office provides educational materials for the counties to use.

4. When a mandatory recipient does not contact the dss within 30 days, the county assigns a primary care provider. The dss will notify each individual by letter of his provider and to explain the program and the correct way to access medical care. It is extremely critical that dss educate SSI recipients about the proper use of program policies and procedures.

5. In order to identify and track SSI Medicaid recipients, an SSI EXEMPT Report (for exempt codes 9900010 & 9900011) is generated monthly and mailed to each CCNC/CA county. Refer to EIS 4200 for additional information on the report.

6. It is strongly recommended that each Community Care of North Carolina/Carolina Access county maintain a list of mandatory SSI Medicaid participants in Community Care of North Carolina/Carolina Access. Document on the list:

a. That a duplicate Medicaid card was ordered following a request.

b. Any request for change of primary care provider by the recipient and date this request is made.

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(X.D.6.)

c. Any request by the primary care provider that a patient be disenrolled with that practice.

If there are any questions about Community Care of North Carolina/Carolina Access (CCNC/CA), please call your Medicaid Program Representative.

E. IV-D Referral

1. Caretakers of SSI children must cooperate with IV-D to establish medical support agreements when the following applies:

a. The caretaker is applying for or receiving Medicaid for herself in any aid program/category except MPW (see MA-2375, Procedures for Child Support Enforcement), and

b. The child meets the criteria listed in MA-2375, Procedures for Child Support Enforcement.

2. Caretakers of SSI children who are not applying for or receiving Medicaid for themselves may choose to cooperate with Child Support. The approval notice for SSI Medicaid instructs the recipient to contact IV-D if there is a child lacking parental support due to absence of one or both parents.

3. EIS will notify IV-D of the new SSI Medicaid case when a child lacking parental support due to absence of one or both parents:

a. Is approved for SSI Medicaid, and

b. Previously had an automated referral to IV-D completed. This continues the link between IV-D and EIS which allows automatic updates between the two systems.

4. Individuals in a pending application or active case in EIS who are already referred to IV-D when approved for SSI may continue to use IV-D services. EIS will

continue to send automatic updates to IV-D for these cases if the SSI Medicaid case is created with the same EIS Individual ID. New SSI Medicaid approvals, including individuals who have never been active in EIS, may also use IV-D services.