Adult Medicaid Manual MA-2350 CERTIFICATION AND AUTHORIZATION

IV. AUTHORIZATION

A. Policy Rule

The period authorized is the portion of the c.p. when all factors of eligibility are met and the individual receives Medicaid benefits.

B. Private Living Arrangement (PLA - Refer to MA-2260, Financial Responsibility Regulations - PLA.

1. Cases with Deductibles:

Authorize the day the deductible is met and through the last day of the c.p., provided all other eligibility factors are also met.

2. Cases With No Deductibles/No Excess Reserve

Authorize the first day of the c.p. through the last day of the c.p.

3. Cases With Excess Reserve:

a. M-AABD, CNNMP, MQB-Q, MQB-B, MQB-E, and MWD

If an applicant is over the reserve limit as of the first moment of the first day of the month, he is ineligible for the entire month even if he reduces his reserve during the same month.

b. M-AABD MN:

An applicant is eligible on the day that reserve is reduced to the allowable limit.

4. When there is both a deductible and excess reserve, and these are met on different dates, authorize on the later of the two dates.

C. Long-Term Care (LTC - Refer to MA-2270, Long-Term Care Need and Budgeting.)

1. Authorize on the first day of the c.p. and through the end of the c.p. for recipients who are in long term care on the first day and all eligibility factors are met.

2. Authorize M-AABD CN-NMP cases on the first day of the month in which reserve is within allowable limits on the first day of the month and all other requirements are also met.

3. Authorize M-AABD MN on the day reserve is reduced to allowable limits and all other requirements are also met.

REISSUED 04/01/11 – CHANGE NO. 01-11

(IV.)

D. Special Situations

1. Disability Cases:

a. Authorize the month of the prospective or retroactive period when all factors of eligibility are met.

b. Authorization of a disability case may never predate the month of disability onset.

c. An individual who is determined to be disabled is considered disabled as of the first day of the month of onset.

2. RSDI Disability Approvals-Subsequent to a Medicaid Denial

Refer to MA-2525, Disability.

E. Authorization in EIS

1. When all conditions of eligibility are met, notify a/r on the appropriate notice and refer to instructions in the EIS User’s Manual for authorization procedures.

2. Follow instructions in EIS User’s Manual regarding when authorization must be updated because of changes in situation.

3. Refer to MA-2320, Redetermination of Eligibility, for instructions to authorize benefits month by month in situations where redeterminations have not been completed timely or timely notice has not expired.