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COMAR 10.09.24.03

377 State of Maryland Medical Assistance Manual Revised July 2012 the reason of “301” for over-scale income to the denial/closure notice that CARES generates for T02. CARES denies/closes MA eligibility for a case trickling to T99, and does not allow the CM to update the medical expense screens to authorize a spend-down.

If the child is ineligible for T02 because the child‟s resources are over-scale and the income is in excess of the standard (LTC cost of care), CARES denies/closes due over- scaling resources (not also due to over-scale income). Therefore, the case manager should add the reason of “301” for over-scale income to the denial/closure notice that CARES generates.

If the child is ineligible for T02 because the child‟s resources are over-scale but the income is within standard for T02, CARES may trickle the T02 Au to T03-T05 depending on the child‟s age. If not, the MA CM should Add-A-Program to determine eligibility for T03-T05.

AU Screened in T03

For a child under age 1: If the income is within 185% FPL, the T03 Au is eligible and certified for 12 months. If the child is ineligible for T03 because the child‟s income is over 185% FPL, but the child‟s income does not exceed the cost-of-care and the child‟s resources are within the T02 standard, the CM should Add-A-Program to determine the child‟s eligibility for T02. If the child is ineligible for T03 because the child‟s income is over 185% FPL, the child‟s income is greater than the cost-of-care and the child‟s resources are within the T02 standard, CARES will apply the T02 cost-of-care rules and the AU will go into spend-down (T99). Since CARES gives the AU Status Reason Code as only “401” to deny for over-scale resources, the CM should add the reason of “301” for over-scale income to the notice that CARES generates. CARES denies/closes the eligibility and does not allow the worker to update the medical expense screens to authorize spend- down. If the child is ineligible for T03 because the child‟s resources are also over-scale for the T02 standard, CARES denies/closes due to over-scale resources (Code 401). In the denial notice that CARE generates, the CM should also add the reason of “301” for over-scale income.

AU Screened in T05

For a child who is under age 19 but at least six years old: If the income is within 100% FPL, the T05 is eligible and certified for 12 months.