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COMAR 10.09.24.04
316 State of Maryland Medical Assistance Manual Revised July 2012
In the event that an applicant fails to qualify in the first coverage group in which they are tested, the local department must test the applicant in other possible coverage groups for which they may qualify. This may include testing eligibility beyond a CARES-generated sprout, as from F99 to the P-track. In order to conduct this additional test, the local department must gather enough information from the applicant to establish which coverage groups may be possibilities. Possible questions for the applicant include, but are not limited to:
Does the ABD applicant have a related minor child in his/her care? Does the FAC applicant (adult or child) have a disabling condition or visual impairment? Is the FAC applicant a Medicare recipient?
Information gathered from questions such as these will enable the local department to test the applicant in alternative coverage groups for which the applicant may qualify. Where there is more than one potential coverage group and the applicant chooses one over another in the Informed Choice discussion, this should be noted in the case narrative.
The declaratory statement (medical coverage statement), ordinarily completed in MCHP applications, should also be completed for TCA and FAC applications. Eligibility in the F- track would not be precluded if it is missing. However, eligibility in coverage group P14 would be precluded if the case trickles to that group and the declaratory statement is missing.
(d) Screening Applications for Medical Assistance Extensions (F02 and F03)
Previously, TCA cases reached the Earnings Extension (F02) and Child Support Extension (F03) only through the “trickle” process. Now CM may initiate F02 and F03 cases through screening process. Screening for the MA extensions is appropriate when the TCA case was closed without the earnings or child support information which would have automatically allowed the case to trickle. A new field (MA EXT) on the MISC screen will be used to initiate the extension. If valid value “D” is used the MA EXT field, the case will not trickle through the F- Track.
For most people, the application should be processed within 45 calendar days of the date you apply. If an applicant is pregnant, their application should be processed within 10 work days, if the case manager has all of their required information. If an applicant is referred to Disability Determination Services for a disability determination, their application will be processed within 90 calendar days, or as soon as possible after your disability determination is complete if the disability determination takes more than 90 days.
(e) Verification Requirements
When an application is received, the local department of social service conducts system clearance (e.g. Client Automatic Resources and Eligibility System (CARES), State Verification Exchange System (SVES), State on-line Query (SOQL) and Maryland Automated Benefits System (MABS) to determine whether the applicant has current Medical Assistance coverage group, to investigate what benefits or income the applicant or spouse is receiving, and to obtain or verify other information related to the application. Information provided by the A/R may be