CCC Staff Process

CCC is assigned a task to process Form H3038-P. Staff must:

determine whether mother and newborn are already active on Medicaid;

if mother and newborn are not active on Medicaid, use all TP 40 eligibility policies and procedures to determine Emergency Medicaid eligibility, except when verifying income and citizenship/alien status;

use the verified income provided to determine CHIP perinatal eligibility to determine Emergency Medicaid eligibility. Note: TIERS will not run financial rules when certifying a recipient for Emergency Medicaid and will instead use the verified income used to determine the woman’s CHIP Perinatal eligibility;

verify all non-financial eligibility points prior to certification using: identity verification sources; and residence verification sources;

use the date Form H3038-P is received as the file date for the Emergency Medicaid and TP 45; and

process Form H3038-P by the 45th date after the file date.

The file date for the TP 45 is usually the date Form H3038-P is received if it includes the newborn's information. Birth outcome information can also be received via the newborn interface or from the person by phone or in writing. When birth outcome information is received after Form H3038-P has already been submitted to the HHSC, a second task is assigned to CCC to process TP 45 coverage for the newborn.

When CCC staff receive a task that includes Form H3038-P dated more than 60 days after the pregnancy due date, CCC must stamp "Received (Date) CCC" on Form H3038-P, to indicate the form was provided after the 60 days from the pregnancy due date. CCC staff must return Form H3038-P along with an application and a letter informing the person that they must apply for Medicaid. The person is instructed to complete the application and return it to the nearest HHSC office or appropriate out-stationed worker, if an out-stationed worker is housed at the hospital where the delivery took place.