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State of Maryland Medical Assistance Manual Revised April 2014

• ON the “DEM1” screen, enter valid value cold “MD” (Mental Disease Facility.) This will generate the Closure code “220”-“Failed Age Requirement.” • Use freeform text to indicate the reason for the case closure on the Notice of Denial. 4. For a recipient admitted for a long-term care stay in an IMD who is between 22 and 64 years old and is MA eligible as a recipient of SSI or TCA: Eligibility for MA is retained unless eligibility for the cash assistance program ends. However, MA is prohibited from paying for the cost of their IMD services. Procedures after eligibility determination for a recipient institutionalized in an IMD: • All cases activity should be documented in the CARES narrative. • Retain the original DES 1000 in the case record. • When a recipient transfers from one IMD to another, a new DES 1000 form should be received by the MA CM to confirm admission to the new facility. “Transfer” should be checked in Part VI of the DES 1000. • When recipient is transferred from an IMD to an acute, sub-acute, or rehabilitative hospital (not a long-term care facility) and then returns to the IMD, the hospitalization is not considered a discharge and does not interrupt the recipient’s institutionalization in the IMD. Since hospitalization does not impact the recipient’s MA long-term care eligibility, a DES 1000 is not used. • When a recipient is discharged from an IMD, to the community, the facility should send a DES 1000 to notify the MA CM (DEWS, financial agent, or LDSS) and the DHMH Health Choice Enrollment Section. The recipient’s eligibility should be redetermined for community MA. If the recipient is being discharged from an IMD for persons under 21 years old, the policies and procedures in Policy Alert 10-9 and its Supplement are followed to redetermine eligibility for community MA.