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Administrative Manual Section: General Administrative Procedures and Compliance Policy Manual Number: 200.020 Chapter: Prohibition Against Concurrent Receipt of Benefits

Legal Authority: 42 CFR 435.403; Tenn. Comp. R. & Regs. 1200-13-20

1. Policy Statement

An individual is prohibited from receiving TennCare benefits from two or more categories of eligibility. This restriction does not apply to individuals who are eligible for a Medicare Savings Program (MSP) and TennCare. An individual is also prohibited from receiving Medicaid benefits from another state concurrent with TennCare Medicaid or CoverKids eligibility.

Tennessee does not reimburse medical expenses using an individual’s Medicaid card from another state. TennCare Medicaid or CoverKids reimburses only on a TennCare Medicaid or CoverKids Identification number.

2. Out-of-State SSI Benefits

If a Tennessee resident is receiving SSI benefits from another state, refer the recipient and her responsible party to the Social Security Administration (SSA) to effect transfer of their SSI and Medicaid benefits to Tennessee. Inform the recipient and his responsible party that the SSA must change the client’s address to the new Tennessee address. The eligibility effective date for TennCare Medicaid will be the date the individual receives SSI in Tennessee

3. Public Assistance Reporting Information System (PARIS)

Tennessee participates in PARIS, which is an information exchange system between states designed to identify individuals who may be receiving benefits or have unreported income in more than one state. Other states may request information to assist in resolving matches concerning individuals who appear to be receiving benefits in more than one state. If TennCare receives a PARIS match indicating that an individual is receiving concurrent benefits in another state, TennCare will attempt to confirm Tennessee residency prior to taking steps to terminate TennCare coverage