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COMAR 10.09.24.03

359 State of Maryland Medical Assistance Manual Revised July 2012 on CARES (if it has not been closed already), suppress the CARES notice, and send a manual QDWI notice (see attached notice). The QDWI coverage group does not cover the premium for Medicare Part B. The individual may elect to participate in Part B and pay the Part B premium to SSA There are annual redeterminations for coverage group S06 because there is 12 month certification period. CARES should issue the redetermination package on schedule. SVES must be reviewed to determine if the person still meets the criteria for QDWI eligibility. All Medicaid redetermination requirements in COMAR 10.09.24.12 must be met. If eligibility as a QDWI is terminated, the CM must determine if the individual is eligible for any other Medicaid coverage group. Termination of Premium HI (Medicare Part A) and QDWI Eligibility Premium- HI for the working Disabled continue until the earliest of; o The end of the month the following the month the individual is notified by SSA that he or she no longer has a disabling impairment. (This can be verified on SVES as “Current Pay Status” N27.) o The end of the month following the month the individual files a request for termination of Premium HI. o The end of the month the individual becomes re-entitled to premium free HI or turns age 65. o The date of death. The individual must receive a notice of the termination at least 10 days before the effective date, including appeal rights. The CARES notice must be suppressed, and a QDWI termination notice muse be issued manually by the CM (see attached notice).

CARES Screens/Procedures

Follow the general CARES procedures for processing an application for Community MA as ABD. The instructions below are to assist with additional steps or information necessary in relation to the S06 Medicaid Coverage Group. The applicant should be tested for eligibility in both S98 and S06. Pend both at the same time. The eligibility for S98 should be tested first.

If the customer is active (“A” status, not “M” status on the STAT Screen in CARES) in S98 or S99 coverage; finalize the AU for the Active S98 or S99 coverage group and allow the CARES notices eligibility coverage group. Suppress the CARES notice for denial of S06. If the countable income causes the S98 AU to go into a preserved status for spend-down (“M” status), DO NOT FINALIZE the S98 case (using reason code “550”) to prevent it from trickling to preserved “M” status for S99. CARES does