Adult Medicaid Manual MA-2410 MEDICARE ENROLLMENT & BUY-IN

XI. INFORMATIONAL MATERIALS SENT TO COUNTIES

A. Code 23 Report

This report from CMS informs the State that the recipient's claim number and/or claim number suffix has been changed. CMS sends a code 23 for an ongoing buy-in transaction or as a response to a State-initiated accretion, deletion or change attempt. The Code 23 Report includes the recipient's name, MID, new HIC

(Medicare claim number), old HIC, SSI indicator, sex, DOB, and transaction code and effective date.

Verify through SOLQ and social security records that the claim number on the case profile, individual data, and RSDI number, and in EIS match the new HIC number on the Code 23 Report (IX.). If not, make appropriate changes to correspond with the social security records information.

B. List of Actions Sent to Baltimore

The List of Actions Sent to Baltimore is a printout of all transactions sent on the monthly buy-in file to CMS in Baltimore.

1. It includes all new accretion and deletion requests as well as requests to change the Medicaid ID number (code 99).

2. Individuals are listed in alphabetical order.

3. Transactions on this report, which are accepted by CMS, should appear on the following month's SOLQ.

4. The List of Actions is forwarded to the counties monthly for information. The IMC must check the list of actions to determine if proper information was sent before requesting clerical action on the DMA-5004, Buy-in Clerical Action. Refer to Part A and Part B Buy-In Transaction Codes, to see transactions.

REVISED 11/01/11 – CHANGE NO. 17-11

(XI.)

C. Medicaid Recipients Reaching Age 65 Who Should Be Enrolled In Medicare Part B

This printout is an accumulative listing of recipients who are reaching 65 years of age and have not enrolled in Medicare Part B or do not have an RSDI claim number entered in the Eligibility Information System (EIS) file.

1. Verify the Medicare claim number (including the suffix) for recipients reaching age 65 from the Medicare card, Bendex, or SOLQ.

2. Enter the Medicare claim number in the RSDI claim number field on the DSS-8125 screen.

3. If the recipient has not enrolled in Medicare, assist him in making the application for Medicare. See VIII. above.

a. The a/r may apply for Medicare coverage once he reaches 64 and nine months of age.

b. Ask the a/r to provide a copy of his birth certificate for proof of age.

c. If the a/r does not have a birth certificate, assist him in obtaining proof of age. See VIII. D. above.