SSI Terminations

Federal Law mandates that a CMD be completed on all SSI terminations before Medicaid can be terminated by DCH. As part of this CMD process, DCH will determine if continued eligibility:

should exist under SSA Section 1619(a) or (b) Work Incentives and, therefore, should be referred to SSA (See 2579 SSI 1619 Individuals ); OR

exists under another Medicaid coverage group and switch the individual to this new Medicaid coverage group.

As part of the automated Ex-Parte process, reports listing the names of individuals who have been converted to a new coverage group will be generated and received via Gateway. Refer to 2750 DCH Reports-Ex Parte Lists for specific instructions on how to complete the CMD process for an A/R terminated from SSI.

The Personal Responsibility and Work Opportunity Act of 1996, commonly referred to as the Welfare Reform Act, specifically prohibits individuals wanted in connection with a felony or in violation of the terms of their parole or probation or an outstanding warrant, from receiving SSI, Food Stamps, TANF benefits, and federal housing assistance. There is no prohibition written into federal law that prohibits these so called “fugitives” from receiving Medicaid. If someone is terminated from SSI due to their “fugitive” status Medicaid cannot be denied for the same reason. The fugitive could still be eligible for Medicaid provided he/she meets the requirements for some other group covered under the State’s Medicaid plan, such as the Adult Medically Needy program.