Standard of Promptness

The eligibility determination for Family Medical Assistance COAs should be completed with real time determinations or as soon as all verification is received. This should take no longer than the following time frames:

10 days from the date of application for pregnant women, regardless of COA

45 days for EMA-PGW

10 days from the date of report for newborns, regardless of COA

This pertains to a child born to a woman who was eligible for and receiving Medical Assistance on the day the child was born who most commonly is approved for Newborn COA but could be approved/dual eligible for another COA, such as Parent/Caretaker.

45 days from the date of application for all other Family Medical Assistance COAs

Calculate the SOP beginning with the date of application. Document the reason for any delays in the case record.

If the SOP date falls on a weekend or holiday, complete the application by the last workday prior to the weekend or holiday.