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MEDICAL SERVICES POLICY MANUAL,SECTION A

A 212 RetroactiveEligibility Other Waiver Programs

2. ARChoices In some cases deemed critical by the DHS RN, the begin date of eligibility may be prior to the date of completion of the case if all eligibility criteria have been met, if the Waiver applicant and Waiver provider made a request for services to the DHS RN prior to certification, and if the provision of services was approved by the DHS RN. The waiver eligibility date will never be established retroactively by the caseworker unless the retroactive eligibility date is authorized by the DHS RN. 3. Assisted Living The DHS RN will provide the begin date basedon the date of application, date of the assessment and Plan of Care is signed, and the date the client entered the facility.

A-212 Retroactive Eligibility-Other Waiver Programs MS Manual 01/01/14 Retroactive eligibility is determined according to the guidelines for each Waiver eligibility group as described below: 1. TEFRA Waiver Retroactive coverage can begin three months prior to the date of application if all eligibility requirements are met. 2. Autism Waiver There is no retroactive coverage in this group. 3. DDS Waiver There is no retroactive coverage in this group.

A-213 Retroactive Eligibility-Medicare Savings Programs (MSP) MS Manual 08/15/14 MSP does not follow the general rule for retroactive coverage. These retroactive coverage periods are described below: 1. For ARSeniors, retroactive coverage can begin three months prior to the date of application. 2. For QMB, there is no retroactive coverage for this group. 3. For SMB and QI-1, retroactive coverage can begin on the first day of the month, three months prior to the application month if all eligibility requirements are met.