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COMAR 10.09.24.12

1207 State of Maryland Medical Assistance Manual Revised July 2012

A 90-day extension will be granted to allow continued MA benefits and inclusion into the automatic redetermination cycle. The coverage groups must be changed from S02 to the appropriate coverage group, i.e., S98, F05, P06, P14, etc. depending upon the age of the individual. Financial eligibility tests are not required to establish the 90-day extension. Income and assets will be considered beginning the month following the 90-day extension. The CM must set an alert to ensure timely completion of the redetermination for continued community MA eligibility beyond the 90-day extension, based upon the assistance unit composition. Appropriate notification must be provided in accordance with current policy and procedures for completing unscheduled redeterminations.

Please note: For individuals who remain eligible for MCHP (P-Track) beyond the 90-day extension, and there is no associated case, the CM must change the D.O. and transfer the finalized case to the appropriate Local Health Department (LHD). Be sure to narrate all case action.

No face-to-face interview will be required during the 90-day extension. The procedures for tardy redeterminations apply if the application for continued eligibility is returned within four (4) months of the month in which the 90-day extension ended, or a new application is filed within that time frame. Individuals determined ineligible to receive MA benefits beyond the 90-day extension must be notified of the finding of ineligibility, the reason for the finding, the COMAR supporting the finding, and the right to request a hearing. The 90-day extension will allow ample time to close the case with timely notice, effective the first day of the month following the 90-day extension.

(2) SSI Terminations with Associated Food Supplement Program Case

During the 90-day extension of MA benefits, non-SSI income must be counted to prevent a QC error and to ensure that the Food Supplements are calculated correctly. Code the earned income type as “FS‟ to prevent the system from counting it for MA, and possibly resulting in the case going into spend-down. If MA goes into spend-down, the system will not generate the proper redetermination notice.

(3 ) Disabled Adult Child (DAC)

A person who is at least 18 years old, who began receiving the SSI benefits on the basis of blindness or a disability, and whose disability occurred before age 22, is referred to as a Disabled Adult Child (DAC). When one of these individuals begins receiving Social Security benefits, based on a parent‟s account that has become aged, disabled, or deceased, the SSA benefit, generally greater than the SSI benefit, results in the DAC‟s loss of SSI eligibility.