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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 170 Chapter 24 Long Term Care

24.59.8 The Benefit Effective December 21, 2017 there was a change in the way Medical ID cards are issued. Instead of the separate blue paper card, the Medical ID card is now included in all Medicaid approval notices. The Medical ID card does not include any date parameters since eligibility may terminate. Medicaid recipients will receive one Medical ID card per case each time there is an approval or renewal for Medicaid for any household member. In situations where retroactive eligibility is established, the Medicaid coverage will be validated appropriately for each back-dated month. CSED waiver services will only be paid on or after the CSED waiver approval date. 24.59.9 REDETERMINATION PROCESS CSED cases are redetermined financially once a year. An interview is not required. The same financial criteria used at application applies at each annual redetermination. When possible, the redetermination process is completed automatically using electronic data matches without requiring information from the client. This redetermination process is initiated by the eligibility system, which matches current information with the Federal Data Services HUB and the Asset Verification System (AVS). If determined eligible after completing the redetermination process, the DoHS will notify the client. The notice will identify the information used to determine eligibility. If the customer agrees with the information, no further action is required. If the client does not agree, he is to report the information that does not match the circumstances. These changes will be treated as a change in circumstance during the certification period. If the automatic redetermination process is successful, the worker will receive a System Generated Alert to confirm continued medical eligibility and waiver enrollment. When the redetermination process cannot be completed automatically, the eligibility system alerts the worker when a redetermination is due and automatically sends a redetermination form to the client. The redetermination form is due by the first day of the 12th month of the certification period. If the redetermination form is not received by the adverse action date, the AG is issued a notice of closure. The Worker must manually schedule the redetermination for SSI and Deemed SSI CSED waiver clients. SSI and Deemed SSI clients must complete the DFA-LTC-5 to complete an CSED waiver redetermination.