NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL
ELIGIBILITY INFORMATION SYSTEM EIS 3900
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ASSETS TRANSFER TRACKING SCREEN
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EIS 3900 – ASSETS TRANSFER TRACKING SCREEN
I. General information
II. PROCESS
III. PROCEDURES FOR KEYING
IV. LOGOFF PROCEDURES
V. COMBINING INDIVIDUAL ID NUMBERS
VI. 8128 ASSETS TRANSFER Discrepancy Report
VII. TRANSFER OF ASSETS – individuals with sanction Report
EIS 3900 – ASSETS TRANSFER TRACKING SCREEN
REVISED 05/01/11 – CHANGE NO. 04-11
I. General information
A. Individuals who apply for or are receiving long term care Medicaid under the Aged, Blind and Disabled program and who transfer an asset for less than market value may have a transfer of assets sanction. If the person leaves long term care while the sanction is in effect, they are not eligible for assistance with in-home health services and supplies. EIS allows entry of a sanction period which prevents the Medicaid payment of these services. The entry of the sanction information also allows the tracking of sanctions for all Medicaid cases.
1. This policy is applicable only to individuals who are applying for or receiving Medicaid under the following aid-program/categories:
• MAA, or
• MAB, or
• MAD, or
• MQB-Q.
2. This does not apply to individuals receiving assistance under the State/County Special Assistance Program (SA).
B. Medicaid will not pay for in-home health services and supplies if a sanction period is entered in EIS. In-home health services and supplies are medically necessary services provided to an applicant/recipient (a/r) by a Medicaid certified provider and include the following:
• Durable Medical Equipment (DME) and related medical supplies such as wheelchairs, walkers, canes, hospital beds, oxygen and oxygen equipment, needed to maintain or improve a recipient’s medical, physical, or functional level.
• Health Services covers home health aide services, skilled nursing, physical therapy, speech pathology and audiology, and occupational therapy provided by a Medicaid certified home health agency to help restore, rehabilitate or maintain a recipient in the home.
REVISED 05/01/11 – CHANGE NO. 04-11
I.B. (CONT’D)
• Home Health Supplies include items such as adult diapers, disposable bed pads, catheter and ostomy supplies provided by a Home Health or Private Duty Nursing (PDN) agency. Individuals in an ACH are not eligible for PDN services.
• Home Infusion Therapy (HIT) covers self-administered therapies such as nutrition therapy (tube feeding), drug therapy including chemotherapy for cancer treatments, antibiotic therapy and pain management therapy.
• Personal Care Services (PCS) are personal care activities such as bathing, toileting, monitoring vital signs, housekeeping and home management tasks essential for maintaining the recipient’s health performed by an in-home aide in a private residence. PCS provided to individuals in an ACH are not subject to this policy.
II. PROCESS
A. The county dss caseworker uses the “Assets Transfer Tracking Screen”, (AT), to enter the evaluation indicator “N” or “Y”.
B. EIS transmits the transfer of assets evaluation indicator and, if entered, the sanction period dates, to the Medicaid claims contractor.
C. If the home health provider provides the service and submits a claim and the:
1. Transfer of Assets indicator is “Y” and the date of service is:
a. For a time within the sanction period, the claim is denied.
b. During a time not included in the sanction period, the claim is paid.
2. Transfer of Assets indicator is blank or “N”, the claim is paid.
REISSUED 02/01/11 – CHANGE NO. 03-11
III. PROCEDURES FOR KEYING
A. From the EIS Update Menu, enter “AT” in the SELECTION field and the Individual ID in the KEY field.
Press ENTER. The following screen is displayed.
B. The Assets Transfer Tracking Screen displays any existing assets transfer data for the individual, including the case ID. The evaluation information section of the screen will be blank if no assets transfer data exists.
C. The Individual ID remains in the KEY field to facilitate additional inquiries.
D. The screen displays the message;
1. “INQUIRY COMPLETE”, if an indicator is present, or
2. “PLEASE ENTER ASSETS TRANSFER INFORMATION”, if there is no existing assets transfer data for the individual, or
3. “INDIVIDUAL ID NOT FOUND ON PENDING OR INDIVIDUAL DATABASE”,
a. If the individual has never received Medicaid benefits and a DSS-8125 has not been keyed to approve benefits for the individual, or
REISSUED 02/01/11 – CHANGE NO. 03-11
III.D.3. (CONT’D)
E. Enter the Option you wish to perform.
“A” = Add
“C” = Change
“D” = Delete
1. The Assets Transfer Tracking Screen will retain up to five lines of sanction information for an individual. However, there will never be more than one “N” indicator allowed. When a sanction period is added to an individual that has an “N” indicator present, the “N” indicator is automatically deleted.
a. If there is no indicator and an evaluation results in the need for a sanction period to be entered, use the “A” option to enter the “Y” indicator and the Begin and End Dates. Or, if the evaluation indicates no sanction period, use the “A” option and enter the “N” indicator.
b. If an “N” indicator is already present and an evaluation results in the need for a sanction period to be entered, use the “C” option to change the “N” to a “Y” and enter the sanction Begin and End Dates.
c. If an additional sanction period needs to be entered and there is already a “Y” with prior Begin and End Dates, use the “A” option in the next available line. DO NOT OVERLAP SANCTION DATES.
Example: Sanction period on AT screen is:
10012004 through 10312006. Another sanction applies for 10012006 through 02282007. Enter a second sanction period of 11012006 through 02282007 or change the original sanction period to end 09302006 and enter a second sanction period of 10012006 through 02282007.
REVISED 05/01/11 – CHANGE NO. 04-11
III.E. (CONT’D)
2. If a sanction period has been entered but it is determined that the period is no longer valid, you must either:
a. Use option “C” and change the invalid Begin and End Dates to the correct valid dates, or
b. Use option “C” and change the invalid segment to “N” and delete the Begin and End Dates if there should be no sanction period present, but the evaluation has been completed, or
c. Use option “D” and delete the invalid segment or segments if the indicator should be blank because an evaluation has not been completed, or if you wish to delete an invalid segment when another sanction period is present.
F. Enter the appropriate evaluation indicator.
“Blank” = No Evaluation completed.
“N” = Evaluation completed. There is no sanction.
“Y” = Evaluation completed and there is a sanction.
G. If “N” is keyed, do not key Begin and End Dates.
H. If “Y” is keyed, you are required to enter the SANCTION BEGIN DATE and SANCTION END DATE. Refer to MA-2240 to determine the dates to enter.
I. Press ENTER.
J. One of the following messages displays.
REVISED 05/01/11 – CHANGE NO. 04-11
III.J. (CONT’D)
If you receive one of the error messages, 2 thru 12 above, correct the error and press ENTER. If all information is correct, you will receive the message: “PRESS ENTER AGAIN TO CONFIRM UPDATE”.
K. If you use the PF3/15 option to cancel, you receive the message: “PRESS PF3/15 AGAIN TO CANCEL UPDATES”. When you press PF3/15 again, any information that was keyed is deleted and the original information is displayed.
L. You may return to other IMS functions at any time.
IV. LOGOFF PROCEDURES
Use the following instructions to sign-off of IMS.
A. From a clear screen, key “/RCL”. Press ENTER.
B. The Banner Screen is displayed.
REISSUED 05/01/11 – CHANGE NO. 04-11
V. COMBINING INDIVIDUAL ID NUMBERS
When an EIS Form 8128 is keyed to combine Individual IDs, there are several things that can happen with the sanction period information associated with the IDs. In some cases, the caseworker is required to re-enter the sanction period information to the active Individual ID.
A. If both IDs have an “N” evaluation indicator, the “N” is retained for the active ID.
No other action is required by the caseworker.
B. If one ID has nothing for assets transfer and the other ID has an evaluation indicator (“Y” with sanction period or “N”), the “Y” with sanction period(s) or “N” are retained for the active ID.
No other action is required by the caseworker.
C. If both IDs have a “Y” indicator and the sanction period(s) have the same Begin and End Dates, the “Y” and sanction period(s) are retained for the active ID.
No other action is required by the caseworker.
D. If both IDs have a “Y” indicator but different sanction periods, no sanction period information is posted to the active combined ID. Both indicators and sanction period information are posted to a discrepancy report entitled “8128 Assets Transfer Discrepancy Report”. The report is located in XPTR at “DHREJA 8128 ASSETS TRANS DISCREP”. See VI. for additional information.
The caseworker is required to determine the correct sanction period information on the report and post it to the active Individual ID.
E. If one ID has a “Y” indicator with a sanction period and the second ID has an “N” indicator, no sanction period information is posted to the active combined ID. Both indicators and sanction period information are posted to a discrepancy report entitled “8128 Assets Transfer Discrepancy Report”. The report is located in XPTR at “DHREJA 8128 ASSETS TRANS DISCREP”. See VI. for additional information.
The caseworker is required to determine the correct sanction period information on the report and post it to the active Individual ID.
REVISED 05/01/11 – CHANGE NO. 04-11
V.E. (CONT’D)
NOTE: THE SANCTION PERIOD INFORMATION FOR THE COMBINED IDS IN A., B., AND C. ABOVE, CAN ONLY BE ACCESSED WITH THE NEW ACTIVE ID.
THE SANCTION PERIOD INFORMATION FOR D. AND E. ABOVE CANNOT BE ACCESSED IN EIS. THE CASEWORKER MUST USE THE DISCREPANCY REPORT TO DETERMINE THE CORRECT SANCTION INFORMATION AND REENTER IT INTO EIS.
F. When the correct sanction period information for the combined Individual IDs has been determined, the caseworker must post this information to the active ID on the “AT” screen. If the caseworker tries to post the sanction period information to the old Individual ID, the error message: “INDIVIDUAL ID DOES NOT EXIST ON INDIVIDUAL OR PENDING DATABASE” is displayed.
VI. 8128 ASSETS TRANSFER Discrepancy Report
The 8128 Assets Transfer Discrepancy Report, located in XPTR at “DHREJA 8128 ASSETS TRANS DISCREP”, lists individuals that had duplicate IDs that were combined but have different sanction period information on each.
A. The report contains:
1. County Number
2. District Number
3. Current ID
4. Recipient’s Name
5. Cross Referenced ID
6. Sanction Information For Each ID
B. The report is sorted by:
1. County
2. District Number
3. New Individual ID Number
The report is posted in XPTR daily when IDs have been combined. It is retained in XPTR for 1098 days. No paper copies are provided.
REVISED 05/01/11 – CHANGE NO. 04-11
VII. TRANSFER OF ASSETS – individuals with sanction Report
The “Transfer of Assets – Individuals With Sanction” report in XPTR lists all individuals with a sanction period in EIS. The sanction period may be active or may have expired.
A. This report is available in XPTR the first workday of each month. The XPTR title is “DHREJA TRANS ASSET SANCTIONS”. Each report is kept in XPTR for 1098 days.
B. The report is updated by the Medicaid claims processing agent on the last workday of each month.
C. The report lists:
1. Individuals With Indefinite Sanction
Individuals with a sanction thru date of 11/30/2010 on the Transfer of Assets tracking screen are listed first. See D. below for a list of the specific information on the report.
2. Individuals With Defined Sanction
Individuals with a sanction thru date other than 11/30/2010 on the Transfer of Assets tracking screen are listed last. See D. below for a list of the specific information on the report.
D. The following information is included on the report for each county.
1. Date and As Of Date (date the report is run)
2. Recipient County Number and County Name
3. District Number
4. Recipient Name
5. Recipient Individual ID Number that is the primary Individual ID Number for the Medicaid Claims processing agent. This id may be a cross referenced Medicaid id number in EIS. If this is the case, there is an * beside the Individual ID number on the report. An ID inquiry in EIS using the Individual ID Number on the report brings forward the information for primary Individual ID Number in EIS.
REVISED 05/01/11 – CHANGE NO. 04-11
IX.D. (cont’d)
E. The report is sorted by:
1. County
2. Individuals With Indefinite Sanction
3. Individuals With Defined Sanction
4. District
5. Recipient Last Name
F. No paper copies of the report are provided.
