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COMAR 10.09.24.03

316 State of Maryland Medical Assistance Manual Revised July 2012 c. If verification is later received that will enable certification in the federally matched coverage group, do “Add-A-Program” or “J” Screen an existing AU, close the original AU, and certify the child in either E01 (for SSI or IV-E foster care of subsidized adoptions) or E02 (for non-IV-E federally-eligible foster care or special needs subsidized adoption).

(E) Post Eligibility Activity Once the MA eligibility is certified on CARES, there is an overnight electronic transfer of the MA date from CARES to MMIS at DHMH. There is also an electronic transfer of absent parent data from CARES to the DHR Child Support Enforcement Administration. The service worker provides information about the absent parents for establishment of child support via the Eligibility Determination Document (EDD) from CARES or the CARES 9708 application form, during the processing of the OHP MA eligibility for foster care cases. If the child was not already MA eligible, DHMH issues the MA card and sends it to the service worker/unit for a foster care child or to the adoptive parent. If the child was already MA eligible, the MA CM should process a request for a duplicate MA card, to assure that the service worker or adoptive parent has the child‟s MA card. The request should be entered the day after the E-track MA eligibility is committed to CARES, using the following CARES procedures: From the CARES Main Menu, select option “L- Financial Mgmt Misc.” On “LMEN” selection option “S- MA Card Reissuance” and enter the Client ID. On the “MACR” (MA Card Reissuance) Screen, verify information and select “Y” in

the “Reissue Another Card” field. Press Enter to commit the request. CARES will return to “LMEN” with a message of “Insert Successful”. Update case narrative to reflect duplicate card request.

Children certified in E01 or E02 are eligible for HealthChoice. If the child is already enrolled in HealthChoice, the child remains with the same Managed Care Organization (MCO) and primary care provider (PCP) when the child‟s coverage group changes to the E-track. The child‟s representative should follow HealthChoice procedures to request a different MCO and/or PCP, if necessary. If the child is not currently enrolled in HealthChoice but was enrolled within the past 120 days, the child is auto-assigned to the previous MCO. The representative may request a change of MCO and/or PCP if necessary. If the child is neither currently enrolled in HealthChoice nor enrolled within the past 120 days, the enrollment broker will send the HealthChoice packet to the representative for selection of an MCO. Children eligible in the State-only coverage groups of E03 and E04 are not enrolled in HealthChoice, but receive the full range of MA covered services on a fee-for-service basis. However, because they are not HealthChoice eligible, they may not be enrolled in the Rare and Expensive Case Management (REM) program.