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COMAR 10.09.24.04

322 State of Maryland Medical Assistance Manual Revised July 2012

When the MA case manager permits declaration of the specific factor of eligibility, the MA case manager should set a “745” alert to follow up at the first redetermination or at the time that the verification is expected to be available. If the A/R has not provided the verifications, the MA case manager should call or write with a reminder of the verifications requirements. If the verification is not received by the first redetermination, MA eligibility should be terminated due to failure to provide verifications

(f)Reapplication(Reactivation Following Rejection of an Application )

Some applications disposed of may be reactivated, however is a case was denied due to excess resources it cannot be. An applicant may not be determined ineligible due to administrative delays. Administrative delays include delays on the part of the State Review Team (SRT) to determine disability within the time frame as well s delays for any reason on the part of an LDSS.

When an applicant is determined ineligible due to a technical factor (citizenship, residence) or excess resources, the application is disposed of and that action is final since the applicant will remain ineligible for any month in which technical or resources ineligibility existed. ( The reactivation period does not apply)

If the applicant reapplies, believing that the factor of ineligibility has overcome, a new application is required and a new period under considering established based on the new application date. The incurred medical expenses from a retroactive period during which technical ineligibility or excess resources existed may be applied to excess income, if any, for the current period.

Retroactive eligibility may concurred by requested with current eligibility upon reapplication, however, the retroactive period may not include any month(s) in which the applicant did not overcome the factor of prior technical or resource ineligibility.

Example:

Application is filed on 4/15/2011. An earlier application was filed on 1/15/2011 and rejected due to excess resources. The period under consideration has not expired but the applicant’s resources were not reduced to an eligibility level until 4/15/2011; therefore, the earliest period that the applicant can become resource eligible is 5/2011. In this instance the period under consideration is 5/2011- 10/2007. Since the applicant can never establish eligibility for the period prior to 5/2011, unpaid medical expenses incurred during that period which will not be covered by a third party may be applied to excess income for the new period.

(g) Extension of Time Standards The 30 to 60 day time standard must be extended to allow applicant sufficient time to provide the required information when: o The examining physician delays or fails to provide disability determination within the 60 day period