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EqualityCare Eligibility Manual

M1001E ICF - Determining Eligibility And Cost Of Care For ICF-MR (Wyoming Life Resource Center) 

 


Purpose:  This section will assist in determining whether an individual is eligible and the cost of care for ICF-MR (Wyoming Life Resource Center) benefits.


Current Policy Effective Date: January 1, 2008

Date Last Reviewed: November 30, 2007

Previous Policy:   July 1, 2007

 

POL 1001E:  DETERMINING ELIGIBILITY AND COST OF CARE FOR ICF-MR (Wyoming Life Resource Center)

 

 1.     Applicants Must Meet Basic Eligibility Factors

 

Reference Section M600 for a description of all basic eligibility factors.

 

 2.     Applicants Must Meet Level of Care Requirement

 

Applicants must be approved for ICF/MR level of care indicated on the LT-MR-104.

 

 3.     Applicants Must Meet Disability Requirements

 

Applicants meeting the level of care requirement per the LT-MR-104 fulfill disability requirements.

 

 4.    SSI Eligibles Do Not Need to Submit Application

 

If SSI is lost, an application will be required to redetermine eligibility.

 

 5.    Clients Meet Temporary Absence Criteria if Absent up to 14 Days Annually

 

Clients meet the temporary absence requirement when they are absent up to 14 days in a year.  Medicaid will pay room and board for the 14-day period.

 

If clients exceed the 14-day temporary absence period, they must do the following:

 

·             Clients must pay privately for room and board expenses.

·             Medical assistance is not terminated.

 

 6.    Applicants Must Meet Income Requirements

 

Require the countable income to be within the maximum income standard per month.  Reference Medicaid Table 1A to see income standards.  Reference Section M901 to determine if income is countable.

 

 7.    Applicants Must Meet Resource Requirements

 

Require the countable resources to be within the maximum resource limit.  Reference Medicaid Table 7 to see resource standards.  Reference Section M801 to determine if resources are countable.

 

 8.    Some Services Withheld for Nonexempt Resource Transfers

 

Nonexempt resources cannot be transferred for less than fair market value during the look-back period prior to application or when a client is receiving benefits.

 

If clients transfer nonexempt resources for less than fair market value, but meet all other eligibility factors, a penalty period must be imposed.  During the penalty period:

 

·          Payment for Wyoming Life Resource Center services must be withheld.

·          Other Medicaid services must be authorized.

 

                Clients must receive notification that they are Medicaid eligible even though room and board will not be covered for the penalty  period.

 

                Reference Section M803 to determine if a resource transfer is exempt.

 

 9.    Benefits Begin First Day of Month of Institutionalization

 

                Applicants are not required to meet the 30-day stay.

 

10.   Clients Pay Patient Contribution

 

Client is required to pay a contribution toward the cost of care.

 

Require the client to pay toward the cost of care when a partial month penalty is imposed from an uncompensated resource transfer.

 

Reference Section M906 for details on calculating the patient contribution.

 

11.   Clients May Pay Prorated Amount

 

If the client does not reside in the facility for a full month, they may pay a prorated amount based on the number of days they resided in the facility.  Reference Section M906 for details on calculating the patient contribution.

 

12.   Clients May Not Pay Patient Contribution First Month

 

                Clients previously Medicaid eligible do not pay a patient contribution during their first month of eligibility.  Clients must pay a patient contribution the first full month following 30 days of placement.

 

13.   Clients in Wyoming Life Resource Center May Continue Receiving Hospice

 

If Hospice-eligible clients enter the Wyoming Life Resource Center after hospice eligibility begins, determine with Hospice if they are paying room and board as part of services. 

 

Hospice benefits must continue to be authorized if clients continue to have a physician’s medical prognosis of six months or less to live.  If clients do not have this medical prognosis any longer, determine eligibility for other Medicaid programs.

 

14.   Clients May Enter Wyoming Life Resource Center from Other Facilities

 

Clients entering Wyoming Life Resource Center must obtain a new LT-MR-104.

 

15.   Clients Must Be Reviewed

 

Clients must be periodically reviewed every 12 months to determine continued eligibility.  Reference Section M1403 for information on reviewing eligibility.

 

A review is not required for SSI clients.

 

Clients must be reviewed for other Medicaid program eligibility before closing cases.

 

16.   Clients May Lose Benefits

 

The case will close on the first day of the next month when any of the following occur:

  

·          Client leaves Wyoming Life Resource Center.

·          Client does not complete review.

·          Client enters a public institution, excluding Uinta Hall.

·          Client dies.

·          Client determined no longer eligible.

 

Reference:

Defining Group:                                  42CFR 435 Subpart F

                               42CFR 435.132

Income:                                                 42CFR 435 Subpart K

Assets:                                                   42CFR 435 Subpart L


Clarifying Information:

 

1.    SSI Eligibles Do Not Require an Application.

 

2.    If SSI is Lost, an Application Will Be Required to Redetermine Eligibility.

 

Training Link:  Not available at this time.

 


Worker Responsibilities:

 

Indicating Eligibility for SSI Eligibles

 

1.       Enter subtype “NT” on MERE screen in EPICS.

2.       If client loses SSI, set individual as “OU” on SEPA screen in EPICS.

2A.        Determine continued eligibility.

2B.        Open new case.

 

Determining Countable Income

 

1.       Refer to Section M901 for information on determining countable income.

 

Determining Countable Assets

 

1.       Refer to Section M800 for information on determining countable assets.

 

Calculating Nonexempt Asset Transfer Penalty

 

1.       Refer to Sections M803 and M804 for information on exempt assets and related penalties.

 

Approving Benefits

 

1.       Enter program type “ME SS” on SEPA screen in EPICS.

2.       For 300% CAP, enter subtype “NW” on MERE screen in EPICS.

3.       For SSI Eligible, enter subtype “NT” on MERE screen in EPICS.

4.       Authorize case on SSRM screen in EPICS, using appropriate code from Medicaid Table 3.

5.       Send approval notice from Medicaid Table 16.

 

Denying Benefits

 

1.       Enter program type “ME SS” on SEPA screen in EPICS.

2.       For 300% CAP, enter subtype “NW” on MERE screen in EPICS.

3.       For SSI Eligible, enter subtype “NT” on MERE screen in EPICS.

4.       Deny case on SSRM screen in EPICS, using appropriate code from Medicaid Table 15.

5.       Send denial notice from Medicaid Table 16.

 

Reviewing Cases

 

1.       Refer to Section M1403 for information on reviewing cases.

 

Closing Cases

 

1.       Close case on SSRM screen in EPICS for the appropriate benefit month, using appropriate code from Medicaid Table 15.

2.       Send closure notice from Medicaid Table 16.