Family & Children's Medicaid Change Notices

A. MA-3215, Processing the Application, has been revised to eliminate days excluded from the application processing time awaiting HCWD enrollment fee and instructions to deny the application if the fee is not paid.

B. MA-3220, Retroactive Coverage, has been revised to include that retroactive coverage does not apply to the Family Planning Waiver program.

C. MA-3230, Eligibility of Individuals Under Age 21

D. MA-3265, Medicaid Family Planning Waiver, has been revised to remove references to the issuance of a “green” Medicaid card and to eliminate retroactive coverage under this program.

E. MA-3330, Citizen/Alien Requirements, has been revised to place auto newborns on Chart 1 (Code 10). In addition, reference to being born in a U.S. hospital has been removed as a result of further research.

A. Remove: MA-3215 pages 3 – 4, and 9 - 10

Insert: MA-3215 pages 3 – 4, and 9 - 10

B. Remove: MA-3220 pages 1 - 2

Insert: MA-3220 pages 1 - 2

C. Remove: MA-3230 pages 1- 34

Insert: MA-3230 pages 1 - 32

D. Remove: MA-3265 pages 1 - 4

Insert: MA-3265 pages 1 - 4

E. Remove: MA-3330 pages 5 - 14, 19 - 20

Insert: MA-3330 pages 5 - 14, 19 - 20

F. Remove: MA-3425 pages 3 - 4

Insert: MA-3425 pages 3 - 4

CHANGE NOTICE FOR MANUAL NO.12-09, AUTO NEWBORN, FAMILY PLANNING WAIVER, SPECIAL NEEDS CHILDREN, HCWD PHASE II

DATE: NOVEMBER 1, 2009

Manual: Family and Children’s Medicaid

Change No: 12-09

To: County Directors of Social Services

Effective: November 01, 2009

I. Background

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA or Public Law 111-3) was signed into law on February 4, 2009. One provision of CHIPRA 2009 is that babies born in the United States whose mother was covered by Medicaid for the delivery are now exempt from having to provide further verification for citizenship and identity.

Additionally, situations involving special needs adoption assistance children and retroactive coverage under the Family Planning Waiver Program have been clarified by CMS. The manual sections are revised to reflect the clarifications.

On June 12, 2009, DMA instructed the counties by terminal message to temporarily suspend Phase II of Health Coverage for Workers with Disabilities (HCWD). Following implementation of Phase II, CMS informed us that expansion of this program would jeopardize the enhanced FMAP under the American Recovery and Reinvestment Act of 2009 (ARRA) for all NC Medicaid programs. Therefore, HCWD Phase II, coverage of disabled workers with incomes above 150% but at or below 200% of FPL, is being eliminated.

Ii. Content of Change

A. MA-3215, Processing the Application, has been revised to eliminate days excluded from the application processing time awaiting HCWD enrollment fee and instructions to deny the application if the fee is not paid.

B. MA-3220, Retroactive Coverage, has been revised to include that retroactive coverage does not apply to the Family Planning Waiver program.

C. MA-3230, Eligibility of Individuals Under Age 21

1. MA-3230 IV. has been revised to eliminate the requirement that the newborn must go home from the hospital with the mother and remain a member of the mother’s household in order to receive Medicaid as an auto newborn. Children whose birth is covered by Medicaid are considered eligible for Medicaid through the month they turn age 1. In addition, auto newborns are considered to have provided satisfactory documentation of citizenship and identity, therefore further documentation is not required.

2. MA-3230 X.F. has been revised to eliminate the requirement to discuss a transfer from the EFCP to M-PW if the individual is pregnant, and the requirement that the baby is only entitled to auto newborn coverage as long as the mother remains eligible for Medicaid under the EFC. A child born to a mother covered by Medicaid under the EFCP is entitled to auto newborn coverage through the month they turn age one, and are considered to have provided satisfactory documentation of citizenship and identity.

3. MA-3230 V.E. has been added to include instructions for children who are covered by NC Medicaid on the basis of special needs who move to another state and return to NC.

4. MA-3230 II.A. has been revised to eliminate HCWD Phase II, coverage of disabled workers with incomes above 150% but at or below 200% of FPL. Continue the eligibility of all those who are currently enrolled in HCWD Phase II through the end of their current certification period. At redetermination, evaluate these recipients for eligibility in all Medicaid programs, including HCWD Phase I for those with incomes at or below 150% of FPL. If the recipient is ineligible in any Medicaid program, send a timely notice and terminate.

It is no longer necessary to keep lists of applicants and contact numbers for

inquiries of those who appear to qualify for HCWD Phase II and not in any other program. DMA will collect all such lists that are currently in existence.

D. MA-3265, Medicaid Family Planning Waiver, has been revised to remove references to the issuance of a “green” Medicaid card and to eliminate retroactive coverage under this program.

E. MA-3330, Citizen/Alien Requirements, has been revised to place auto newborns on Chart 1 (Code 10). In addition, reference to being born in a U.S. hospital has been removed as a result of further research.

IIi. Effective date and Implementation

The FPW change is effective November 01, 2009. Apply this policy to any applications or redeterminations taken on or after November 01, 2009.

The auto newborn and special needs changes are effective November 01, 2009. Apply this policy to any applications or redeterminations taken or pending on or after November 01, 2009.

The HCWD policy change is effective upon receipt.