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Page 9 – State Medicaid Director

Social Security Administration (SSA)

SSA is a critical partner with the States and with CMS in implementing this section of MIPPA. As part of MIPPA, SSA is responsible for:

Transmitting the MSP application file to the State Medicaid agencies; Providing MSP model applications to individuals requesting assistance; and Coordinating outreach activities with the States in connection with LIS.

SSA has worked closely with CMS and with the States to assure that this is a smooth process. SSA has consulted with the States and CMS to coordinate the transmission of the MSP application file, and SSA will be providing liaisons in each region to provide for technical support and training. However, it is important to note that SSA is not responsible for MSP eligibility issues. Any eligibility issues need to be sent to CMS through the Regional Offices for response.

Other Eligibility Issues

During consultation with State eligibility staff and advocates, two issues have been raised:

(1) whether there is a need for an actual “wet” or physical signature on the MSP application; and (2) the need for citizenship verification.

Signature: Because the State is directed to treat the data from SSA as initiating an application for MSP benefits as if it was submitted directly by the applicant, it is not necessary for the State to require a “wet” signature. The State’s receipt of SSA data from the LIS application will suffice for this purpose.

Citizenship: States are not required to document citizenship for MSP applicants unless SSA denied the LIS application because the applicant was not eligible for Medicare. For example, the applicant might not have enough quarters of coverage to be eligible for premium-free Part A, although he or she might be eligible as a QMB to have Medicaid pay the Part A premium. According to 42 CFR 435.406, individuals entitled to or enrolled in any part of Medicare are exempt from citizenship documentation requirements. A person applying to have the Part A premium paid as a QMB would not meet this regulatory exemption. In such a case, a State would be required to document citizenship as required under 42 CFR 435.407.

Outreach and Training

As part of MIPPA, grants were awarded to State Health Insurance Assistance Programs (SHIP), State Agencies on Aging, Area Agencies on Aging (AAA), Aging and Disability Resource Centers (ADRC), Native Americans Tribal Organizations, and local communities to: increase program awareness; provide assistance to seniors, caregivers, and those with disabilities on Medicare to apply for benefits; and to establish a national resource center to support these efforts.