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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

18 REVISED 11/01/11 – CHANGE NO. 17-11 (VIII.B.)

b. When an individual has a Medicaid card from another state, verify if the provider will accept the other state's Medicaid. If not, initiate emergency card procedures.

2. Establish SSI eligibility. SSI eligibility can be established by verifying the individual is on the SDX Exception List, on-line SDX, SOLQ, or by the emergency certification.

a. First, verify whether the individual is on the exception list because data in EIS did not match with data on the SDX. In this situation, do not issue an emergency card. Work the exception report and the card is issued automatically by EIS in the nightly cycle.

b. If the case is not on the exception list, view the on-line SDX. When the individual is on the SDX in current pay status (CO1), SSI eligibility is established.

c. Counties may use SOLQ to verify SSI for emergency Medicaid. Using SOLQ should eliminate the need most often for using the DMA-5050, Emergency Certification for Medicaid.

d. When the individual is not on the exception list, the on-line SDX, or SOLQ, the DMA-5050, Emergency Certification for Medicaid, must be completed by SSA to establish SSI eligibility and North Carolina residence.

e. The DMA-5050, Emergency Certification for Medicaid, may be initiated by DSS or SSA. The completed form:

(1) Verifies that the individual is eligible for SSI in the current month, and

(2) Verifies the individual is a North Carolina resident, and

(3) Provides all the necessary identifying information needed to issue a Medicaid card.

3. When SSI eligibility has been established via the SDX, SOLQ, or the Emergency Certification form:

a. Enter an administrative DSS-8124 (unsigned and untracked). Mark ADMINISTRATIVE.

b. Use exact Social Security number, last name, first name, and date of birth as the SSA record. This ensures the same EIS Individual ID is used when the SSI Medicaid case is created.