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2238.06.00 DISCONTINUANCE DUE TO WHEREABOUTS UNKNOWN
When mail is returned as undeliverable with no forwarding address, efforts must be made to confirm the correct address, including checking documents in the case records, calling the individual at the phone number(s) on record, checking all available electronic resources and sending a 2032 address verification request to the last known address in the case record or to an authorized representative. Sending the pending request form may of course result in another returned mail, but it is an important step to ensure that the client is not discontinued inappropriately.
If it becomes necessary to discontinue assistance because the client cannot be located and mail has been returned as undeliverable with no forwarding address, timely notice is required.
If the closed member’s address becomes known during their eligibility period (the time before their next redetermination would have been due), the closure must be rescinded.2
2238.10.00 CLOSED CASE FILES
When all the AGs in a case are closed, the system will automatically transfer the case to closed files 90 days after the effective date of the discontinuance.
2238.15.00 CERTIFICATES OF MEDICAID COVERAGE
On August 21, 1996, The Health Insurance Portability and Accountability Act (HIPAA) was enacted. This law is designed to improve the availability of health insurance to working families and their children, including eligible individuals who have previous coverage under Medicaid.
The provision of the law that directly affects the Division of Family and Children is the requirement concerning the issuance of certificates of creditable coverage. An individual, who enrolls in a health care plan that imposes an exclusionary period for a pre-existing medical condition, may be able to have that period reduced by prior coverage under another plan, including Medicaid.
The DFR must issue the Certificate of Medicaid Coverage (FI Form 0021) to the individual so that he can present it as documentation to the new health insurance plan. Periods of Medicaid eligibility beginning July 1, 1996, for all full coverage categories and the pregnancy-related category, except as explained below, are included as creditable coverage:
• Exclude QMB-Only, SLMB-Only, and QI coverage. Unlike the pregnancy-related categories, these categories do not provide coverage of regular Medicaid services. • Exclude months of ineligibility for which a recovery claim has been established and is currently in dispute through the administrative hearing process.