Basic Considerations

The Alliant Health Solutions (AHS) or other DMA approved entities determine the LOC for the above mentioned COAs.

For ABD Medicaid eligibility, LOC is defined as nursing facility care and is verified by receipt of an approved instrument indicating that the A/R meets the LOC requirement for that COA. The distinction between different levels of care is not relevant for Medicaid eligibility purposes.

In some instances, a LOC may only be approved for a limited period of time. Refer to 2577 Limited Stays for procedures for a limited stay.

If a LOC is not approved, DMA is notified by the agency responsible for the decision. DMA then notifies DFCS of non-approval by letter. DFCS cannot approve Medicaid under a Medicaid Cap COA but must review eligibility under other COAs.

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Basic Considerations

Official source

The Alliant Health Solutions (AHS) or other DMA approved entities determine the LOC for the above mentioned COAs.

For ABD Medicaid eligibility, LOC is defined as nursing facility care and is verified by receipt of an approved instrument indicating that the A/R meets the LOC requirement for that COA. The distinction between different levels of care is not relevant for Medicaid eligibility purposes.

In some instances, a LOC may only be approved for a limited period of time. Refer to 2577 Limited Stays for procedures for a limited stay.

If a LOC is not approved, DMA is notified by the agency responsible for the decision. DMA then notifies DFCS of non-approval by letter. DFCS cannot approve Medicaid under a Medicaid Cap COA but must review eligibility under other COAs.