Family & Children's Medicaid Change Notices

A. Eligibility for 60 Day Postpartum Coverage

B. Notification of Changes in the Coverage Period Due to Pregnancy Terminating Earlier or Later Than Anticipated

C. Policy for Evaluating Ongoing Medicaid Eligibility When Pregnant Woman Coverage Ends

DMA CHANGE NOTICE 13-01, Terminations and Pregant Woman Coverage

DATE: APRIL 2, 2001

Manual: Family & Children's Medicaid

To: County Directors of Social Services

Effective: May 1, 2001

I. description of change

MA-3220 is revised:

• To clarify that coverage for the 60-day postpartum period applies regardless of the reason the pregnancy terminates.

• To add instructions for notifying the pregnant woman of changes in her coverage when her pregnancy terminates earlier or later than anticipated, thus causing the period for which she is eligible to be shortened or lengthened.

• To provide requirements for evaluating ongoing Medicaid eligibility when the woman ceases to be eligible for Medicaid coverage as a pregnant woman. Her authorization may not end until a determination of eligibility under all other Medicaid aid program/categories is completed.

• To ensure that the pregnant woman is given timely notice before pregnant woman coverage ends. The new timely notice code is "1F" and will be in the EIS Manual, Section 4000 Appendix B, effective May 1, 2001.

• To delete references to deprivation as an eligibility requirement for caretaker coverage.

II. implementation instructions

The manual is revised effective May 1, 2001. Apply these changes as follows:

A. Eligibility for 60 Day Postpartum Coverage

This is not a change in policy but rather a clarification of existing policy. Upon receipt of this notice, ensure that you are authorizing the 60 day postpartum period regardless of the reason for the termination of pregnancy.

B. Notification of Changes in the Coverage Period Due to Pregnancy Terminating Earlier or Later Than Anticipated

Apply this policy for any pregnancy that terminates on or after May 31, 2001.

C. Policy for Evaluating Ongoing Medicaid Eligibility When Pregnant Woman Coverage Ends

Apply this policy for any pregnant woman whose Medicaid eligibility as a pregnant woman ends on or after May 31, 2001.

III. Maintenance of manual

Remove MA-3220

Insert MA-3220, effective 5/1/01

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

Paul R. Perruzzi

Director

[This policy material was researched and written by Jackie Franklin, Policy Consultant, Medicaid Eligibility Unit.]