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COMAR 10.09.24.05

549

State of Maryland Medical Assistance Manual Revised July 2012

DPSCS Staff is Responsible for:

Identifying all inmates who appear to meet the criteria. Completing a need assessment to determine if the inmate is a candidate for the pre release application process for Medicaid and/or FIA benefits. Developing a release plan indicating whether the inmate will reside in the community or an institution. Conducting the required face-to-face interview for benefits, assisting the inmate with completing the DHR/FIA application form for Medicaid and FIA benefits and forwarding the application and accompanying information to the LDSS at least 60 days before the inmate’s expected release dare including a release plan an application for benefits, DHR/FIA 402B and DHMH 4204 completed by the DPSCS medical department, DHR/FIA 161 Authorization to Release Information form signed by the customer or representative all the verifications and documentation necessary for the LDSS to determine eligibility for benefits (e.g., address and living arrangement upon release, SSN, income, resources, verification that application has been made for all potential benefits). Contacting the SSA about the status of the customer’s application for SSDI/SSI if need. Telephoning the LDSS Inmate Liaison in the jurisdiction where the customer will reside to alert them the application and information are being forwarded and to provide contact information for the DPSCS Inmate Liaison. Telephoning the LDSS Inmate Liaison as soon as release date is set And on the release date: o For inmates released to the community, informing the inmate of the status of the application for Medicaid and/or FIA benefits and the LDSS address or o For inmates released to an institution, making arrangements for the transfer and notifying the LDSS Inmate Liaison of the transfer.

The LDSS is Responsible for:

Reviewing and processing the DHR/FIA application and accompanying materials,

requesting any additional information form the DPSCS Inmate Liaison (sending a 1st

reminder notice, a 2nd reminder and then denying the application if the information is

not received by the due date given in the 2nd reminder notice) and completing a referral

to the SRT for a disability determination, if necessary.

Upon Notification by DPSCS of the Inmate’s Release:

Finalizing the eligibility determination if all of the required information is received; Sending the appropriate notice to the applicant in care of the DPSCS Inmate Liaison and if the customer is determined eligible, fax information on a C-TAD to DHMH on the day of discharge so that DHMH will activate the case on MMIS to assure that the next day