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COMBINED MANUAL

ISSUE DATE 11/2018

STATE MEDICAL REVIEW TEAM (SMRT)

0012.15.06

The State Medical Review Team (SMRT) determines disability as required by specific programs. See Minnesota Health Care Programs Eligibility Policy Manual 2.3.2.2 (MA-ABD Certification of Disability) for more information on specific program requirements.

SMRT performs disability determinations for individuals seeking a disabled basis of eligibility for Medical Assistance (MA). A SMRT disability certification establishes a basis of eligibility for MA programs, including home and community-based service (HCBS) waivers, MA under the Tax Equity and Fiscal Responsibility Act (MA-TEFRA), and MA for Employed Person with Disabilities (MA-EPD). A SMRT disability certification also gives people access to state funded programs including the Consumer Support Grant (CSG), Family Support Program (FSP), and Special Needs Basic Care (SNBCS). SMRT completes disability determinations for people not certified disabled by SSA. SMRT certifies disability using the same disability criteria as the SSA.

Referral Process

SMRT referrals must be made even if the person has been referred to SSA, because the SSA disability determination process can be long. The county, tribal or state servicing agency completes a SMRT Referral for a Disability Determination and submits it through Integrated Services Delivery System (ISDS). For those who have access to the ISDS system, use the link at the ONEsource Manual and follow the procedures for submitting a referral under the ISDS Instructions.

Expedited Case Criteria

SMRT expedites the disability determination process in the following situations where the person is likely to meet disability criteria:

● The person has a condition that appears on the SSA Compassionate Allowance Listing (CAL).

● The person is awaiting discharge from a facility and can be discharged immediately if MA is approved.

● The person has a potentially life-threatening situation and requires immediate treatment or medication.

● Other circumstances that may jeopardize a client's benefits. The circumstance is reviewed and accepted on a case by case basis.

Continuing Disability Review

People certified disabled by SMRT need a continuing disability review every 1 to 7 years. Disability standards are different for children and adults, so at age 18, a child must be evaluated under the adult standards. Newborns certified disabled due to a low- birth weight must be reviewed prior to age 1.

Counties may contact SMRT directly at: SMRT Hotline 651-431-2493 or 1-800-235-7396. SIR Email to the SMRT Case emailbox at dhs.smrt@state.mn.us