400.08 EMERGENCY CERTIFICATION FOR SSI ELIGIBLE INDIVIDUALS -

COE-020 The State Data Exchange or SDX file issued by the Social Security Administration (SSA) transmits newly approved SSI recipients to DOM on a daily basis. Upon receipt of the approval, eligibility for the SSI recipient is placed on file during an overnight batch process. However, in certain situations, referred to as systems limitation cases, there is a delay in the SSI process of placing SSI eligibility on file. This sometimes occurs when SSA has an SSI recipient placed in forced or manual pay situations. If a newly approved SSI recipient has an emergency need for Medicaid coverage, such as urgently needed medication or hospitalization, and the individual’s SSI/Medicaid eligibility will likely experience a delay due to a system’s limitation on the part of SSA, a request for an Emergency Certification of the individual’s SSI eligibility is issued by SSA to DOM. Central Office staff reviews each request and places the SSI eligibility on file in the most appropriate manner. This includes placing the SSI recipient in the worker entered COE-020. When SSI eligibility transmits to DOM in the normal manner (via the SDX file), the SSI eligibility closes the COE-020 eligibility and opens SSI eligibility (COE-001). The Emergency Certification may be a request by SSA for a closed period of time, in which case COE-020 will be used to place the needed eligibility begin and end date on file.