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UPDATED: NOVEMBER 2007

INTRO 1

(MRG) INTRODUCTION TO THE MEDICAID REFERENCE GUIDE AND INSTRUCTIONS FOR USE

The Medicaid Reference Guide (MRG) was designed for local social services districts in New York State. Its purpose is to assist districts in determining eligibility for applicants/recipients of Medicaid.

It is not intended to be a thorough training course in Medicaid, but a reference book, like a dictionary or an almanac. It is not intended to be read from cover to cover, but used at a worker’s desk, consulted as needed. It is not intended to replace eligibility workers or supervisors, but to increase their effectiveness and improve their job performance.

The Medicaid Reference Guide is arranged in five sections: Categorical Factors; Income’ Resources; Other Eligibility Requirements and Reference. Marked tabs separate the sections. At the end of each section there is also an index to that section. Within each of the five sections there are subsections, the titles are in bold print at the top of each page. The pages are numbered consecutively through all five sections. A Glossary is found at the front of the manual and a cumulative/master index at the end of the book.

The subsections contain some or all of the following headings in the left margin of each page:

Description: A statement of the subject covered in the subsection. This may include a definition, means of identification or other statements, which generally describe and set the subject apart from other subjects.

Policy: A brief statement of the policy governing the situation. This may be derived from one or more sections of the Law or Department Regulations.

References: A listing of the Laws and Regulations consulted when determining the policy, which applies to the situation. For more information refer to these sections of Law or Regulations.

Interpretation: A statement of what to do when confronted by a specific situation. An expansion of policy as it relates to case situations and why certain policies are applied as they are.

When to Verify: The case circumstances when information must be verified. This relates to the application form, the case record and the circumstances of the applicant/ recipient.

Verification: Acceptable sources of verification in the order of acceptability and advice on the type of information to be recorded. References to specific documents