Page 16
16
NC FAST Job Aid: MA/MAGI DSS-8110 Notice of Modification, Termination or Continuation of Public Assistance.
(2) Follow NC FAST Job Aid: Sanctions for Transfer of Assets to impose the sanction and continue the MQB case.
(3) Send the DHB-5106, Medicaid/PACE Referral, to notify the PACE organization the individual is no longer eligible for payment of PACE services.
b. If ineligible for MQB, terminate the case.
(1) Send a timely DSS-8110 Notice of Modification, Termination, or Continuation,. See NC FAST Job Aid: MA/MAGI Notice of Modification, Termination or Continuation of Public Assistance.
(2) After the timely notice period has expired, send the DHB-5106, Medicaid/PACE Referral, to notify the PACE organization the beneficiary is no longer eligible for payment of PACE services.
c. SSI Beneficiary
(1) End date PACE evidence in NC FAST and follow policy in MA- 2240, Transfer of Assets.
(2) Generate a timely DSS-8110 Notice of Modification, Termination, or Continuation, in NC FAST, to impose the sanction and notify the a/b that Medicaid will not pay for PACE services during the sanction period. The caseworker should ensure that the correct reason and case outcome are selected. See NC FAST Job Aid: MA/MAGI DSS-8110 Notice of Modification, Termination or Continuation of Public Assistance.
(3) Send the DHB-5106, Medicaid/PACE Referral, to notify the PACE organization the beneficiary is no longer eligible for payment of PACE services.
D. Other Changes
1. When a PACE beneficiary enters a skilled nursing facility (SNF) and remains enrolled in the PACE program, the PACE organization is responsible for the beneficiary’s cost of care. See section VI.A-B (above) for budgeting instructions.
2. When a PACE beneficiary enters a SNF and disenrolls from the PACE program, the PACE organization is responsible for the beneficiary’s cost of care through the month of disenrollment. See section X.A (above) for instructions for voluntary or involuntary disenrollment, including how to make Medicaid Eligibility corrections when needed.