Family & Children's Medicaid Change Notices
A. MA- 3420: Re-enrollment packets are no longer mailed to MIC and NCHC recipients for re-determinations of eligibility. References to the automated re-enrollment procedures for MIC/ NCHC have been removed.
B. MA-3420 III.A. 1. MIC and NCHC cases due for re enrollment will appear on the Case Management Report three (3) months prior to the end of the certification period.
C. MA- 3420. III.A. 2: An ex parte review for re-determinations of eligibility for both MIC and NCHC programs for children under the age of 19 will be utilized. This will require careful management of the Medicaid caseload and the case worker must be proactive in assisting the client through the process.
D. MA-3420 III.A.2.b.: DMA-5075, Verification Checklist for MIC/NCHC Re-enrollments will be used as the base document for an ex parte re-enrollment.
E. MA-3420 III.A.2.c.: Do not react to changes in income that occur after the first day of the
F. MA- 3420 VIII.B.3 and IX.C.1: Have been updated to reflect changes from Administrative Letter 03-11 to authorize NCHC cases for an additional month when the timely notice period will not expire before cut-off.
A. The last automated MIC/NCHC re-determination packets were mailed on June 1, 2011 for reviews due July, 2011. The recipients must return these re-enrollment forms by June 25. Follow current automated re-enrollment procedures for these reviews.
B. Case Management Report dated June 1, 2011 includes MIC/NCHC cases due for review August, 2011.
C. The DMA-5067, Re-Enrollment Information Notice, will be mailed on or about June 15, 2011 to all MIC and NCHC recipients with a review due August, 2011.
D. NCXPTR reports DHREHC NCHC RE-ENROLLMENT and DHREJ MIC RE-ENROLLMENT list the cases sent the DMA-5067. These reports have been revised and may be used for tracking purposes.
E. Begin using the ex parte process for reviews due August, 2011 or later.
A. Remove: MA-3420, Re-enrollment, pages 1-28.
B. Insert: MA-3420, Re-enrollment, pages 1-28.
CHANGE NOTICE FOR MANUAL NO. 12-11, SIMPLIFICATION OF RE-ENROLLMENT FOR MIC/NCHC
DATE: JUNE 15, 2011
Manual: Family and Children’s Medicaid
Change No: 12-11
To: County Directors of Social Services
Effective: July 1, 2011
I. Background
Administrative letter 03-11 provided information and instructions to Medicaid and NC Health Choice workers and supervisors regarding the end of the code 80 terminations for Medicaid for Infants and Children (MIC) and North Carolina Health Choice (NCHC) cases effective April 2011.
The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA or Public Law 111-3) includes many provisions that gives states the tools needed to effectively enroll eligible children in Medicaid and Children’s Health Insurance Program (CHIP) coverage. Section 203 of CHIPRA provides avenues to ensure that children eligible for Medicaid and CHIP have a fast and simplified re-enrollment process.
The North Carolina Division of Medical Assistance (DMA) will discontinue the automatic mailing of re-determinations for MIC and NCHC cases. The case worker will use the Case Management Report to identify MIC/NCHC cases due for re-determination.
II. Content of Change
A. MA- 3420: Re-enrollment packets are no longer mailed to MIC and NCHC recipients for re-determinations of eligibility. References to the automated re-enrollment procedures for MIC/ NCHC have been removed.
B. MA-3420 III.A. 1. MIC and NCHC cases due for re enrollment will appear on the Case Management Report three (3) months prior to the end of the certification period.
C. MA- 3420. III.A. 2: An ex parte review for re-determinations of eligibility for both MIC and NCHC programs for children under the age of 19 will be utilized. This will require careful management of the Medicaid caseload and the case worker must be proactive in assisting the client through the process.
The recipient will no longer receive a postcard (DMA-5067) to alert them that a review packet will be mailed. However, the DMA-5067/ DMA-5067S is revised, renamed the Re-Enrollment Information Notice and will be mailed to the recipient on the 15th day of the 10th month of the certification period. The notice explains it is time for a review and re-enrollment forms are no longer required. The DMA-5067 will explain the importance of reporting changes, types of changes to report and how to report any changes. Changes must be reported by the first day of the following month.
D. MA-3420 III.A.2.b.: DMA-5075, Verification Checklist for MIC/NCHC Re-enrollments will be used as the base document for an ex parte re-enrollment.
E. MA-3420 III.A.2.c.: Do not react to changes in income that occur after the first day of the
11th month of the certification period, unless the assistance unit was ineligible based on income verified in the ex parte process. This change will be included in MA-3300, Income, in a separate change notice.
F. MA- 3420 VIII.B.3 and IX.C.1: Have been updated to reflect changes from Administrative Letter 03-11 to authorize NCHC cases for an additional month when the timely notice period will not expire before cut-off.
III. IMPLEMENTATION
A. The last automated MIC/NCHC re-determination packets were mailed on June 1, 2011 for reviews due July, 2011. The recipients must return these re-enrollment forms by June 25. Follow current automated re-enrollment procedures for these reviews.
B. Case Management Report dated June 1, 2011 includes MIC/NCHC cases due for review August, 2011.
C. The DMA-5067, Re-Enrollment Information Notice, will be mailed on or about June 15, 2011 to all MIC and NCHC recipients with a review due August, 2011.
D. NCXPTR reports DHREHC NCHC RE-ENROLLMENT and DHREJ MIC RE-ENROLLMENT list the cases sent the DMA-5067. These reports have been revised and may be used for tracking purposes.
E. Begin using the ex parte process for reviews due August, 2011 or later.
IV. Effective date
This policy is effective July 01, 2011. Apply this policy to MIC/NCHC redeterminations with a certification period ending August 31, 2011 or later.
This change will impact other sections of the F&C Manual. A separate change notice will be issued for the manual sections affected by this change.
V. Maintenance of manual
A. Remove: MA-3420, Re-enrollment, pages 1-28.
B. Insert: MA-3420, Re-enrollment, pages 1-28.
If you have any questions, please contact your Medicaid Program Representative.
Craigan L. Gray, MD, MBA, JD, Director
(This material was researched and written by Susan Castle, Policy Consultant, Medicaid Eligibility Unit.)
