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Title 5: Centrally Administered Programs Page 17 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Application Processing Revised August 20, 2010 Medicaid Screening and Referral Process Once the result of the Medicaid eligibility determination is known, process the hawk-i application or renewal as follows:

If the Medicaid eligibility decision is: Take this action on the hawk-i application: Denial due to income exceeding limits Continue to determine hawk-i eligibility Denial due to failure to cooperate Deny for failing to cooperate with Medicaid Approval Deny due to receipt of Medicaid but no hawk-i denial letter needs to be issued Denial for other reasons, such as the child is not a U.S. citizen or qualified alien Deny application Referrals From hawk-i to Medicaid Legal reference: 441 IAC 86.4 At the time of initial hawk-i application, if it appears the child may be eligible for Medicaid, make a referral to the Department for a determination of Medicaid eligibility as follows:

1. Forward a scanned copy of the original application and copies of any accompanying information and verification to the Department within 24 hours of receipt of the application, or the next working day, whichever is sooner.

2. Maintain a copy of all documentation sent to the Department and a log tracking the disposition of all referrals.

3. Notify the family that the referral to Medicaid has been made. Return to the family any original verification and information that was submitted with the application and retain a copy in the file record. The Department will consider the referral as an application for Medicaid. The time limit for processing the referred application begins with the date the original application is date-stamped as being received by the third-party administrator.