Family & Children's Medicaid Change Notices

A. MA-3205, Conducting A Face-To-Face Interview

B. MA-3230, Eligibility of Individuals Under 21, has the following clarifications:

A. Remove: MA-3205, Conducting A Face-To-Face Interview, pages 17-18.

E. Remove: MA-3230, Eligibility of Individuals Under 21, pages 27-30.

CHANGE NOTICE FOR MANUAL NO. 19-07, EXPANDED FOSTER CARE PROGRAM CLARIFICATION

DATE: NOVEMBER 21, 2007

Manual: Family and Children’s Medicaid

Change No: 19-07

To: County Directors of Social Services

Effective: December 1, 2007

i. Background

The Family and Children’s Medicaid Manual Change Notice 16-07, issued October 1, 2007, implemented the Expanded Foster Care Program (EFCP). Since the implementation of the Expanded Foster Care Program there have been several questions regarding the policy and information contained in MA-3230, Eligibility of Individuals Under Age 21. This change notice clarifies the Expanded Foster Care Program (EFCP) along with corrections to previous policy information.

iI. CONTENT OF CHANGE

A. MA-3205, Conducting A Face-To-Face Interview

1. If an individual has questions about a Certificate of Creditable Coverage refer him to Electronic Data Systems (EDS) at 1-800-688-6696 or Automated Voice Response (AVR) at 1-800-723-4337.

2. Adds MA-3205, Figure 5, Explanation of The Effect of Transfer of Asset (s) On Medical Assistance Eligibility. Caseworkers must give this fact sheet to the a/r at each application taken and each redetermination started on or after November 1, 2007.

B. MA-3230, Eligibility of Individuals Under 21, has the following clarifications:

1. Prior to automatically placing eligible children age 18, 19, and 20 who aged out of foster care at age 18 into the Expanded Foster Care Program (EFCP), evaluate for all Medicaid programs/categories, excluding Medically Needy and Family Planning Waiver, without regard to assets or income through the month they turn age 21. If eligible, approve in the appropriate program/category. If ineligible, place into EFCP.

2. Caseworkers should discuss the option of transferring into MPW, (the positive and negative) with a pregnant recipient covered under EFCP. The age of the EFCP a/r is important. If the pregnant woman is over 20, MPW may be the better program to

insure she and the child get adequate coverage. In order for the newborn to be guaranteed 13 months of automatic newborn coverage, the mother must receive under MPW, AAF, MAF, C or N, MIC-N, MAD, MAB C or N. If she receives under MPW, her benefits will be limited to pregnancy related services.

If the recipient receiving Medicaid under the EFCP is pregnant or becomes pregnant she can receive pregnancy related care covered by Medicaid under the EFCP thru the month of her 21st birthday.

If the recipient delivers her baby while covered under the Medicaid for EFCP, the baby is only entitled to coverage as long as the mother continues to be eligible for Medicaid under the EFCP.

Both mother and child must be evaluated for coverage under other Medicaid programs should the Medicaid coverage under the EFCP end.

3. Applying for all benefits to which an applicant may be entitled is one of the federal requirements for Medicaid eligibility. If a person does not comply, they are not eligible and therefore you must deny the application.

IIi. EFFECTIVE DATE AND IMPLEMENTATION

This policy is effective December 1, 2007. Apply this policy at each redetermination started on or after December 1, 2007, and each application taken on or after December 1, 2007.

iv. MAINTENANCE OF MANUAL

A. Remove: MA-3205, Conducting A Face-To-Face Interview, pages 17-18.

Insert: MA-3205, Conducting A Face-To-Face Interview, pages 17-18, and Figure 5,
pages 1 and 2.

E. Remove: MA-3230, Eligibility of Individuals Under 21, pages 27-30.

Insert: MA-3230, Eligibility of Individuals Under 21, pages 27-30.

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

William W. Lawrence, Jr., M.D.

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