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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 8

SSI MEDICAID – AUTOMATED PROCESS

(IV.) B. Approval Notice

When SSI is approved and an SSI Medicaid case is created in EIS, an automated Medicaid approval notice is generated that night. See DMA-5101, SSI Approval Notice.

C. Medicaid Card Issuance

1. For new SSI approvals, EIS issues Medicaid cards for SSI Medicaid approvals the same night the case is created in EIS. The State mails the cards from Raleigh the next work day. EIS generates the SSI Medicaid Straggler Register daily in NCXPTR.

2. Ongoing SSI Medicaid recipients are issued a yearly Medicaid card by EIS. An SSI/Medicaid Regular Run Register is generated in NCXPTR for identification. Regular run is the 11th work night from the end of the month.

V. LIMITATIONS TO MEDICAID ELIGIBILITY FOR SSI RECIPIENTS

A. Refusal to Provide Third Party Resource (TPR) Information

Providing TPR is not a requirement for SSI, but it is a requirement for all Medicaid programs. When an SSI applicant refuses to provide TPR to SSA, he is advised by SSA that he is not eligible for Medicaid. No action is required by the dss until the recipient contacts the dss.

1. Identification

a. Individuals who refuse to provide TPR information are indicated on the SDX by an “R” for the Medicaid Eligibility Code and an "R" for the Third Party Insurance indicator.

b. This information is also reported on either the SSI Approval -Medicaid Denial (TPR Refusal) Report (see V.A.2., below) or the TPR Refusal - Medicaid Terminated Report (see V.A.3., below). Refer to EIS 4200 for further information on these reports.

NOTE: Active SAA, SAD, and HSF cases are not terminated. TPR refusal is reported on the TPR REFUSAL-SSI INDIVIDUAL RECEIVING SAA/SAD/HSF Report. This report is for informational purposes.