101.05.05 LOW INCOME SUBSIDY (LIS) APPLICATIONS RECEIVED FROM SSA

For individuals who apply for the Low-Income Subsidy (LIS) with the Social Security Administration (SSA), the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires SSA to forward an electronic application to the state Medicaid agency to determine if the individual is eligible in a Medicare Savings Program (referred to by DOM as Medicare Cost-Sharing programs, consisting of QMB, SLMB and QI). An individual indicates their desire to apply for eligibility to be determined under the Medicare cost-sharing programs when applying for Medicare and/or Social Security benefits and checking “yes” to the question that asks about applying for “Extra Help” in paying for Medicare expenses. Electronic applications are received daily from SSA. When the electronic application is received by DOM, the following occurs: • The system checks the recipient file to determine if the individual is currently eligible for Medicaid. If the individual is eligible, the LIS application is placed on a report in Reports On-Line that indicates the LIS application was not registered because the individual was eligible for Medicaid. • If the individual is not currently eligible, the system registers a pending LIS application. • Each regional office must complete their assigned LIS applications by first reviewing the information submitted by SSA on the LIS file. Accept the attested information on the LIS application without further verification and approve the applicant unless: o the income attested on the application is over the income limit; or o the worker is aware of information that is not compatible with the attestation. • If additional information is needed to make a decision on income eligibility, issue applicable Request(s) for Information to secure the needed verification to approve or deny the LIS application.