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COMAR 10.09.24.03

311 State of Maryland Medical Assistance Manual Revised July 2012 (A) Notification by the Service Worker and IV-E Specialist

A service unit (SU), which shows the type of service for the child, is created for each child concerning foster care, kinship care, or subsidized adoption. This is based on the demographics, service information, and proper enumeration provided by the service worker. Either the existing Client ID is matched or, if there is no existing Client ID, a new one is created for the child.

The service worker promptly advises the FIA MA CM of a child in foster care or subsidized adoption who needs to be certified for E-track OHP MA eligibility. The MA CM is also informed if retroactive eligibility should be determined based on the child‟s living circumstances prior to the OHP application month (e.g., newborn abandoned in hospital, child living with parent(s) or caretaker relative, child in LTC facility for less than a full calendar month). The service worker acts as the child‟s representative for purposes of filing the MA application. The service worker must provide all available information and verifications requested by the MA CM, including related to retroactive eligibility and unpaid medical bills. The IV-E specialist provides information to the MA CM about the child‟s IV- E eligibility. The MA eligibility determination should not be delayed by the IV-E determination. If the child meets technical eligibility for MA and the IV-E specialist has not yet determined IV-E eligibility when the MA application is being processed and finalized, the MA CM should PEND the application under Medical Coverage group E02 and complete the eligibility determination process. If the child is later determined to be IV-E eligible, the MA CM should “Add-A-Program” or “J” Screen an existing E01 AU and complete the eligibility process for an E01 AU as of the 1st of the month after the MA CM is notified by the IV-E specialist.

(B) Screening and Pending the MA Case When the MA CM is notified by the service worker of a foster care or subsidized adoption child requiring an OHP MA eligibility determination: Perform an inquiry in CARES to research and determine if the child is a member of another AU as active, pending, closed or denied. Because the service AU has already been opened by the service worker, these cases should already be known to CIS, and a match should be made to the client on the database. Make every effort to screen the child for an existing Client ID to prevent assigning multiple IDs. If more than one ID exists, refer to CARES Bulletin 98-17, Multiple Client IDs, for how to close the duplicate ID. Note: When a child is adopted, there is actually a break with the old AU and Client ID number. The child may get a new Social Security number (SSN), also. Only if a complete break is not intended for the adopted child would the old SSN, AU, and Client ID be linked on CARES with the new identifiers.