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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 68 Effective Month: September 2023

101.12 PROCESSING DOM EMPLOYEES/FAMILY MEMBERS CASES Cases for DOM Office of Eligibility employees, members of their households and immediate family members require special processing and maintenance as follows: • DOM employees must not process their own application, redetermination, or change. They must not directly view, add, remove, replace or edit system information or documents and verifications in the case record. • Further, DOM employees must not process or maintain case(s) that include a member of their household or immediate family. They must not process the application, redetermination or change on these individuals’ cases. They must not directly view, add, remove, replace or edit system information or documents and verifications in the case record. • Immediate family includes the employee’s spouse, ex-spouse, children, stepchildren, ex-stepchildren, children’s spouses and the following relations to the employee or employee’s spouse or ex-spouse: mother, father, stepparent, brother, sister, niece, nephew, grandparent, grandchildren. • Individuals living in the home with the employee are included as immediate family members even if they are not one of the relationships listed above. • DOM Office of Eligibility employees, household members and their immediate family members must be marked as DOM employees in the system to limit system access to all members of the case. • Cases involving family and friends can potentially represent an impropriety or conflict of interest to an employee; therefore, it is the employee’s responsibility to inform the supervisor if the application or case of a family member or friend has been assigned to them. • DOM employees must never directly or indirectly influence or request that another DOM employee process an application for themselves, family members, household members or friends outside of normal assignment and authorization processes. • Individuals who fail to follow the guidelines for processing applications for employees and their family members are subject to disciplinary action.