Page 36
36
(5) Authorize CAP cases the day after the last day of the sanction.
loading…
loading…
36
(5) Authorize CAP cases the day after the last day of the sanction.
(a) Enter the CAP effective date in NC FAST.
(b) When the individual becomes eligible for CAP, re-calculate the deductible for the certification period according to instructions in MA- 2280, Community Alternatives Program (CAP),V.
(6) For cases with PML, convert the number of days in the sanction-ending month to a dollar amount. (a) Multiply the number of sanction days (if less than the full calendar month) by $384 (average private daily rate).
(b) Add this to the first month’s PML amount regardless of whether the person has a zero PML.
(c) Do not reduce the sanction dollar amount by any UMN or income protected for spouse or dependents at home.
(d) If the full sanction period (including the fractional days) ends on the last day of the sanction-ending month, do not convert to a dollar amount. The a/b is ineligible for that entire month. b. New Request/ Transfer of Asset Information Provided After Termination
(1) If an active Medicaid beneficiary was terminated from cost of care for failure to provide but is still receiving in another Medicaid program and has now provided the information needed for the transfer of assets evaluation:
(a) If an uncompensated transfer is now established, the start date of the sanction is applied the first day of the month following the termination month or the date they meet all other eligibility criteria if not the first day.
(b) If no uncompensated transfer is established, there is no sanction. Restore coverage for institutional services effective the first day of the month following the termination month.
(2) Caseworkers must begin to evaluate the transfer of assets information within 30 calendar days after the local agency receives the request/information.
D. Spouses both institutionalized
1. When both spouses are institutionalized, requesting CAP, or receiving in- home health services and supplies: