Page 17
North Carolina Department of Health and Human Services AGED, BLIND AND DISABLED MEDICAID MANUAL
MA-1100 AGED, BLIND AND DISABLED
SSI MEDICAID – COUNTY DSS RESPONSIBILITY
17 REISSUED 11/01/11 - CHANGE NO. 17-11 (VII.) C. Individual Eligible for In-Home Health Services and Supplies
When it is established that the recipient is eligible for payment of in-home health services and supplies, send the recipient a manual approval notice to continue assistance with these services.
D. Individual Ineligible for In-Home Health Services and Supplies
1. If the individual is ineligible for assistance with in-home health services and supplies due to a transfer of resources sanction, send the recipient a manual DSS- 8110/DSS-8110S, Notice of Change In Benefits, to terminate assistance with these services. Refer to MA-2240, Transfer of Resources, for procedures.
2. Medicaid assistance continues for other covered services.
E. Assets Transfer Tracking Screen
When the transfer of resources evaluation is completed, update the evaluation indicator and/or sanction period in EIS. Refer to MA-2240, Transfer of Resources and EIS-3900, Assets Transfer Tracking Screen, for procedures.
VIII. EMERGENCY CERTIFICATION FOR MEDICAID
A. There may be some instances when an SSI recipient needs a Medicaid card before EIS can automatically issue a card. This may occur when:
1. A newly approved SSI recipient has not received Medicaid due to SSA lag time in updating the SDX or between receipt of SDX and processing of this data by EIS.
2. An SSI recipient recently established residency in North Carolina and is not yet on North Carolina's SDX.
3. The SDX does not verify eligibility due to a problem with the SSA system.
B. Procedures
When an individual requests emergency Medicaid:
1. Document an emergency situation exists.
a. An emergency situation exists when there is an immediate medical need that cannot be met without a current Medicaid card. For example, an individual needs heart medication and the pharmacist will not fill the prescription without a Medicaid card.