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Example 2: The LIS/MSP data file is received on February 10 for Applicant Lou. The LIS application date recorded on the file is January 4. Based on Lou’s income, she is approved for QMB and authorized on March 15. MA L is effective April 1 which is the month after eligibility is determined. The MIPPA legislation did not change this rule for QMB which does not offer retroactive coverage. This 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.

2050.10.00 INITIAL SYSTEM PROCESSING OF LIS/MSP APPLICATION (MED 4) There are three possible LIS decision types: adjudicated LIS denial, non-adjudicated LIS denial, and LIS approval. Adjudicated LIS denial: In this situation, SSA collected and verified all income and resource information and denied the LIS application. MSP will be denied, and a system-generated notice will be sent to the applicant without further follow up by a worker. The MSP denial notice provides the website address for more information on the MSP and the telephone number of the Area Agency on Aging (AAA) which has an outreach grant for the MSP. The AAA will send the individual an MSP application upon request. Non-adjudicated LIS denial: In this situation, the SSA has accepted self-declaration that the applicant and spouse, if applicable, have resources more than the LIS limit. Question 3 on the LIS application asks if the applicant’s resources exceed the LIS limit. If the applicant checks “yes”, a non-adjudicated LIS denial results. If the applicant does not opt out of applying for the MSP, then SSA will send the application to the State. Follow up processing of the application for MSP is required by the worker as explained in Section 2050.20.00.

LIS approval: In this situation, the SSA has collected and verified information and issued a determination that the applicant is eligible for the LIS. Follow up processing of the application for MSP is required by the worker as explained in Section 2050.20.00. A system generated acknowledgment letter will be sent to the individuals who received LIS approvals and non- adjudicated denials. For applicants with no previous or current case, the notice will explain that an MSP application has been received and they may be contacted for verifications. Applicants who have a current application pending will be advised that processing on their case will continue including eligibility for MSP. For individuals already receiving MSP benefits, the notice will state that they are already covered by the MSP and to call the DFR if they have any questions. 2050.20.00 VERIFICATION AND ELIGIBILITY DETERMINATION (MED 4)