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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

21 REVISED 11/01/11 – CHANGE NO. 17-11 (X.) D. Community Care of North Carolina/Carolina Access (CCNC/CA)

SSI Medicaid recipients are required to participate in Community Care of North Carolina/Carolina Access (CCNC/CA) unless they also receive Medicare. CCNC/CA participation is optional for Medicare beneficiaries.

1. New SSI Medicaid recipients will have an exempt code automatically assigned by EIS. These exempt codes will be:

a. 9900010 for SSI Medicaid recipients who are required to participate in the program, or

b. 9900011 for SSI Medicaid recipients who have Medicare and for whom participation is optional.

2. The SSI Medicaid approval notice gives a brief explanation of CCNC/CA and instructions to contact the county dss within 30 days to choose a primary care provider.

3. When the recipient contacts the dss by phone or in person, an Income Maintenance Caseworker is responsible for providing program education and a list of participating primary care providers from which to make a choice. The State CCNC/CA office provides educational materials for the counties to use.

4. When a mandatory recipient does not contact the dss within 30 days, the county assigns a primary care provider. The dss will notify each individual by letter of his provider and to explain the program and the correct way to access medical care. It is extremely critical that dss educate SSI recipients about the proper use of program policies and procedures.

5. In order to identify and track SSI Medicaid recipients, an SSI EXEMPT Report (for exempt codes 9900010 & 9900011) is generated monthly and mailed to each CCNC/CA county. Refer to EIS 4200 for additional information on the report.

6. It is strongly recommended that each Community Care of North Carolina/Carolina Access county maintain a list of mandatory SSI Medicaid participants in Community Care of North Carolina/Carolina Access. Document on the list:

a. That a duplicate Medicaid card was ordered following a request.

b. Any request for change of primary care provider by the recipient and date this request is made.