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MEDICAL SERVICES POLICY MANUAL,SECTION A

A 200 Health Care CoveragePeriods

A-216 Retroactive Eligibility-Foster Children MS Manual 01/01/14 Retroactive coverage for foster children follows the rule for the coverage category in which the foster child is placed with the following exceptions: 1. Non-Title IV-E Adoptive Children with Special Needs-May be certified for retroactive coverage for up to three months prior to the month of application if all the conditions of eligibility are met and if there are unpaid medical bills for this period. If the adoption assistance agreement was not in effect in the retroactive months, then eligibility cannot be established under these provisions but must be established under other Medicaid guidelines. 2. Title IV-E Children who enter Arkansas from another State-May receive up to 3 months retroactive coverage if it is established the child did not receive Medicaid benefits from the sending state in the retroactive months and if the child incurred medical bills in Arkansas during the retroactive months.

A-217 Retroactive Eligibility-Pregnant Woman MS Manual 01/01/23

Retroactive eligibility for Pregnant Women (PW) is determined according to the guidelines for current PW eligibility determination. The applicant should have alleged medical expenses for the retroactive period. (Refer to the “No Look Back” policy at MS C-205 and I-610). The begin dateof the retroactive period will be entered in the system at certification (when authorized in conjunction with current PW eligibility). For Full PW, if application for retroactive PW coverage is made after termination of the pregnancy, the retroactive period may not begin morethan three (3) months prior to the date of application, and the retroactive period must end no later than the last day of the month of delivery (for example, the applicant will not be eligible for the postpartum coverage). (Refer to MS C-205.) NOTE: Retroactive coverage for Unborn Pregnant Woman will follow the rules for the type of pregnancy coverage her eligibility falls in, Full Pregnant Woman as stated above.

Proceduresfor authorizing retroactive eligibility only (for example, “fixedeligibility”) are found in (MS A-220). If application for retroactive PW coverage is made after termination of a pregnancy and coverage after the month of delivery is also requested, a separate application must be made in the appropriate category to provide coverage for the month(s) following the expiration of the PW coverage.