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DocuSign Envelope ID: 3289A281-EC13-40C5-A56D-BE1F23756321 North Carolina Department of Health and Human Services AGED, BLIND AND DISABLED MEDICAID MANUAL MA-1000 6

SSI MEDICAID – AUTOMATED PROCESS

(III.E.) 7. In the unusual situation that SSA does not react to changes reported by the client or dss and it is causing a hardship for a recipient or provider, contact DMA, Medicaid Eligibility Unit. A policy consultant will work with you on a case by case basis.

F. Buy-In

SSI recipients who are eligible for Medicare are automatically accreted for buy-in by SSA. Buy-in is effective the first month of Medicaid eligibility. SSI recipients remain on buy-in until Medicaid is terminated. See MA-2410, Medicare Enrollment and Buy-In.

IV. SSI APPROVAL

When SSI is approved for an individual, the information on the SDX is matched to EIS to determine if the SSI individual is already in EIS. The purpose of matching is to prevent duplicate EIS individual ID's and benefits. If the individual is not in EIS, EIS creates a new case. If the individual is found in EIS, EIS creates a new case for the individual and closes or deletes him from the existing case, or in some cases modifies the existing case. Refer to EIS 4200, Part 3 for information. Also follow instructions in MA-1100, SSI Medicaid/County DSS Responsibility for county dss responsibility when an active Medicaid recipient or applicant in EIS is approved for SSI.

When the Social Security Number of an individual on the SDX matches with an individual in EIS but one of the other criteria does not match or the social security number is found more than once in EIS, EIS creates an exception report called the "SDX Exception List" which is online in EIS. The county dss must determine if the individuals are the same. It is very important to work the exception report weekly. See EIS 4200, Part 2 for instructions to resolve the discrepancies. UNTIL THE DISCREPANCY IS RESOLVED, EIS CANNOT PROCESS THE SSI MEDICAID CASE AND/OR ISSUE MEDICAID.

A. Reports

To assist with case management, EIS generates the report "SSI Medicaid Created/Modified in EIS" when a current EIS case or individual is modified as a result of an SSI approval, and when an SSI Medicaid case transfers into a county. These reports are displayed in NCXPTR. The last six versions are kept on-line. Each situation is identified separately. The EIS county number, district, aid program/category, casehead, case number, case id, SSI recipient name, and individual ID number are listed for each case. Any pending action deleted by EIS as a result of a case termination is also listed.

Refer to EIS 4200, Part 8 for instructions for this report.

See below for a chart of all the SSI Medicaid reports.