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COMAR 10.09.24.05

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State of Maryland Medical Assistance Manual Revised July 2012

the Medicaid card is issued and Eligibility Verification System will verify for providers that the customer is Medicaid- eligible. The LDSS should print MMIS Recipient Screen 1 the next day for verification.

(b) Institution for Mental Disease (IMD) A person between 22 and 64 years old institutionalized in an IMD is not Medicaid- eligible until the individual is discharged from the IMD to the community or to another type of medical institution such as a general hospital or nursing facility. An IMD includes such long- term facilities as:

Psychiatric hospital, residential treatment center (RTC) for children or Regional Institute

for Children and Adolescents (RICA); Intermediate care facility- alcoholic (ICF-A) and Residential drug-free treatment program.

If an individual enters an IMD before age 21, the recipient may remain Medicaid-eligible as an institutionalized person in the IMD up to the 22nd birthday. If the recipient is discharged from the IMD and then is readmitted and institutionalized at 21 or older, the recipient loses Medicaid eligibility. Therefore, Medicaid covers a recipient’s services in an IMD for individuals under age 21 until the earlier of the following dates that the recipient:

Is determined to no longer require the IMD services; Is unconditionally discharged from the IMD; Reaches age 22; or Loses Medicaid eligibility for other reasons.

(c)Conditional Release or Convalescent Leave from an Institution for Mental Disease

A person on conditional release or convalescent leave from an IMD is not considered to be institutionalized in the IMD, with one exception. An individual younger than 22 who is receiving inpatient psychiatric services for individuals under 21 is considered institutionalized in an IMD until the earlier date that the individual is unconditionally released from the IMD or reaches age 22. For an individual under age 22, conditional release or convalescent leave must involve a change of residence to community residence, not to a licensed and certified long term- care facility, in order to alter the individual’s status as institutionalized in an IMD. Conditional release includes a child’s placement in foster care. An individual under age 22 is considered a community resident beginning with the first full month of deinstitutionalization.