Family and Children's Medicaid Admin. Letters

DMA ADMINISTRATIVE LETTER NO: 02-11, FEDERAL POVERTY LEVEL CHANGE REVIEW FOR ONGOING MQB-B & E CASES

DATE: 03/17/11

SUBJECT: Instructions for Ongoing MQB-B & E Cases

DISTRIBUTION: County Departments of Social Services

Medicaid Supervisors

Medicaid Eligibility Staff

I. Background

ABD Change Notice 04-11, FPL Income Limit Changes, instructed that an administrative letter would be forthcoming with instructions on how to work the NCXPPTR Report, titled “Poverty Potential Eligibility for Program Review,” for MQB-B and E cases. This Administrative Letter contains those instructions.

II. Implementation instructions for ongoing mqb-b & E Cases

A. NCXPTR Report, Poverty Potential Eligibility for Program Review

The report titled “Poverty Potential Eligibility for Program Review” (“DHREJA POV POT ELIG FOR PROG REV) is available on XPTR. The report compares the countable income to the New Poverty Level for the current aid program/category. The Minimum Income column lists the new “minimum” amount of the federal poverty level for the recipient’s current aid program/category.

B. For April 1, 2011 or later, apply the new income limits to establish eligibility for the ongoing certification period.

1. EIS will not automatically update the cases on this report. You must pull the MQB-B and E cases on the report.

2. Compare countable monthly income to the amount listed in the Minimum Income Limit column (current MQB-B and MQB-E cases).

a. If the poverty level increase causes a recipient’s income to be equal to or less than the Minimum Income Limit, evaluate for greater benefit aid program/categories.

b. Transfer the case to the appropriate aid program/category and send an adequate notice.

c. Complete review of the cases on the report and take the appropriate action by the pull cutoff date in April (4/26/11).

d. Document the results of the case review and maintain the report for your MPR to review at a later date.

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

Craigan L. Gray, MD, MBA, JD

Director

CLG/wja

(This material was researched and written by William Appel, Policy Consultant, Medicaid Eligibility Unit.)

For questions or clarification on any of the policy contained in these manuals, please contact your local county office.