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MEDICAL SERVICES POLICY MANUAL,SECTION O

O 423 Reporting Requirements

Reporting Requirements MS Manual 01/01/14 There will be no periodic reporting requirements for UP-MN.

Retroactive Eligibility MS Manual 01/01/14 If all of the UP requirements are met in any of the 3 months prior to UP-MN application and if there are unpaid Medical bills, retroactive coverage may be given for any of the 3 retroactive months.

UP-MN Spend Downs MS Manual 01/01/14 If all of the eligibility requirements with the exception of income are met, e.g., countable earnings (at less than 100 hours per month) are over the MNIL and if there are unpaid Medical bills, a Medically Needy Spend Down may be considered.

O-430 Medically Needy Pregnant Women Categories MS Manual 01/01/23 Pregnant Women (Re. MS B-230) may be considered for Medically Needy-EC or SD, if they do not meet the need requirements for PW No-Grant. If a pregnant woman’s income, resources, or both exceed the limits for PW No-Grant, the PW’s income and resources will be compared to the Medically Needy MNIL and MNRL to determine eligibility in PW-EC or SD. If a pregnant woman has income above the MNIL but below two hundred percent (200%) of Poverty Level, then SOBRA PW eligibility will be determined prior to determining eligibility for Spend Down.

NOTE:The unborn child will always be counted in the need standard for the pregnant woman.