Page 31

30

discontinuance. Further, eligibility should extend back to the date of discontinuance. Refer to IHCPPM 2238.25.00 and 1610.50.00 (for pregnancy-related change processing). An individual who appeals a denial or discontinuance which had become effective may file a reapplication at any time. He is not to be denied the right to reapply pending the decision of the Administrative Law Judge (ALJ). If the hearing decision is in his favor, the DFR is to take adjusting action as directed in the decision. If the DFR action is sustained, the reapplication is to be processed in the usual manner. The DFR is not to delay the processing of a reapplication taken under these circumstances until the hearing decision is issued as this is not considered an extenuating circumstance for pending a case beyond the time standard.

2050.00.00 MSP APPLICATIONS FROM SSA LIS DATA FILE (MED 4)

On January 1, 2010, in accordance with the Medicare Improvements for Patients and Provider Act of 2008 (MIPPA – P.L. 110-275), the SSA began using a revised application for the Medicare Part D Low-Income Subsidy (LIS) that tells applicants that their application will be sent to the State Medicaid agency unless the applicant checks a box opting out of the referral. Once SSA makes the LIS eligibility determination, the person’s information will be transmitted to the State via the LIS/MSP data file.27 IEDSS will process this file daily and generate worker notifications for every application received. The LIS/MSP data file acts as an application for the Medicare Savings Program (MSP). The applicant will not be asked to sign a separate MSP or Medicaid application. An eligibility interview is not to be scheduled for the LIS/MSP applications that come from Social Security, but the MSP/paper applications require an interview.

2050.05.00 THE MSP APPLICATION DATE (MED 4) The date of the LIS application is the protected date for establishing MSP eligibility. The date that is used to start the 45-day processing clock is the match date that the file is received by IEDSS. The application date is the date the applicant applies for LIS through SSA. Retroactive eligibility is determined from the application date. Example 1: The LIS/MSP data file is received on February 10 for Applicant Joe. The LIS application date recorded on the file is January 4. Based on Joe’s income, he is approved for SLMB and authorized on March 15. MA J is effective October 1 which is 3 months retroactive based on the protected date of January 4. The Lis application was processed within the allowable time standard as it was authorized within 45 days of the date that the LIS/MSP match was received.