us-ms/manual/dom/chip/epm-chapter-101 — Mississippi Division of Medicaid Eligibility Policy and Procedures Manual Chapter 101 Coverage Groups and Processing Applications and Reviews

101.01 Introduction

101.02 Coverage Of The Categorically Needy In Mississippi

101.02.01 Mandatory Categorically Needy – Magi Related

101.02.02 Mandatory Categorically Needy - Abd

101.02.03 Mandatory Categorically Needy – Special Groups

101.02.04 Optional Categorically Needy – Magi-Related

101.02.05 Optional Categorically Needy – Abd

101.03 How To Apply

101.03.01 Applicant

101.03.01a Deceased Applicants

101.03.01b Non-Applicants

101.03.02 Dom Application Form(S)

101.03.03 Signature Requirements

101.03.04 Representatives Authorized To Act For An Applicant

101.03.05 Who Can File The Application

101.03.06 Access And Accommodation In Applying

101.03.07 Reasonable Efforts To Assist

101.04 Filing The Application

101.04.01 Right To Apply

101.04.02 Request For An Informal Medicaid Eligibility Opinion

101.04.03 Submitting An Application And Application File Date

101.04.04 Protected Application Dates For Medicaid Applicants

101.04.05 Applications Received From Ms Residents Out-Of-State

101.04.06 Out-Of-State Applicants

101.04.07 Residence Change During The Application Process

101.04.08 Where To File The Application

101.04.09 Voter Registration

101.05 Medicaid Applications Filed Through Another

101.05.01 Applications For Ssi Applicants

101.05.02 Applications For Foster Children And Adoption

101.05.03 Account Transfers (At’s) Received From The Ffm

101.05.04 Applications Received From The Common Web Portal

101.05.05 Low Income Subsidy (Lis) Applications Received From Ssa

101.05.06 Hospital Presumptive Eligibilty (Hpe)

101.05.07 Presumptive Eligibility For Pregnant Women (Pep)

101.06 Interviews With Dom

101.06.01 Interview Discussion

101.06.02 Concluding The Interview

101.07 Standards Of Promptness

101.07.01 Regional Office Responsibilities

101.07.02 Exceptions To Timely Processing

101.07.03 Abd Standards Of Promptness

101.07.04 Magi-Related Standard Of Promptness

101.08 Processing Applications

101.08.01 Making An Eligibility Decision

101.08.02 Use Of Collateral Contacts

101.08.03 Requesting Information From The Applicant

101.08.03a Electronic Data Sources Utilized By Dom

101.08.03b Electronic Data Sources Utilized By The Ffm

101.08.04 Supervisory Review

101.08.05 Application Actions

101.08.06 Compliance After Denial

101.09 Combination Magi And Abd Applications

101.10 Eligibility Dates

101.10.01 Beginning Dates Of Medicaid Eligibility

101.10.02 Beginning Dates Of Chip Eligibility

101.10.03 Termination Dates

101.10.04 Retroactive Medicaid Eligibility

101.10.04a Retroactive Medicaid For Abd Applications

101.10.04b Retroactive Medicaid For Magi-Related Applications

101.10.05 Retroactive Medicaid For Deceased Applicants

101.10.06 Retroactive Medicaid For Ssi Eligibles And Filling In Gaps

101.11 Notification

101.11.01 Advance Notice

101.11.02 Exceptions To Advance Notice

101.12 Processing Dom Employees/family Members Cases

101.13 Service Delivery Systems

101.14 Continuous Eligibility For Children

101.14.01 Early Termination Reasons For Children

101.14.02 Deemed Eligible Infants

101.14.03 Adults

101.15 The Redetermination Or Renewal Process

101.15.01 Regular Redeterminations Or Renewals – Magi & Abd

101.15.01a Frequency Of Reviews

101.15.01b Processing Children Currently Due For Review

101.15.01c Processing Children Not Currently Due For Review

101.15.01d Processing An Application And A Review

101.15.02 Assignment Of Review Due Dates

101.15.03 Administrative Ex Parte Renewals

101.15.04 Pre-Populated Renewals

101.15.05 Returned Mail From Redeterminations

101.15.06 Timely Processing

101.15.07 Timely Authorization

101.15.08 Ex Parte Reviews

101.15.09 Ssi Reviews Required For Ssi Terminations

101.15.10 Receipt Of Regular Review Forms

101.15.11 Disposition Of A Regular Review – Abd And Magi

101.15.11a Approval Of A Regular Review

101.15.11b Reduction Or Termination Of Benefits

101.15.12 Requested Information Provided After Closure

101.16 Special Reviews

101.16.01 Recipient Reporting Requirements

101.16.02 Change Reporting Requirements - Abd

101.16.03 Change Reporting Requirements – Magi Programs

101.16.05 Taking Action On Reported Changes

101.17 Reinstatements

101.17.01 Information Provided Prior To Effective Date Of

101.17.02a Renewal Closures Requiring Reinstatement

101.17.02b Renewal Reinstatement Not Required

101.17.03 Corrective Action