MEDICAL ASSISTANCE

AS OF: 07/01/2009 07:01

0300                 MEDICAL ASSISTANCE PROGRAM OVERVIEW.. 28

0300.05             MEDICAL ASSISTANCE PROGRAM PURPOSE. 28

0300.10             PROGRAM ADMINISTRATION.. 29

0300.15             CATEGORIES OF MEDICAL ASSISTANCE. 29

0300.15.05          Categorically Needy. 29

0300.15.10          Medically Needy. 29

0300.20             SCOPE OF SERVICES. 29

0300.20.05          Medical Services Provided. 30

0300.20.05.05       Emergency Room Co-Payment Required. 31

0300.20.05.10       EPSDT. 32

0300.20.05.15       Abortions, Rape, or Incest 33

0300.20.05.20       Abortions, To Save the Life of the Mother 34

0300.20.05.25       Organ Transplant Operations. 35

0300.20.05.30       Transportation Services. 36

0300.20.05.35       Pharmacy Services. 38

0300.20.05.35.05    Pharmacy Services Cost Sharing Requirements. 38

0300.20.20          Waiver Programs. 39

0300.20.25          MA Payment Policy. 39

0300.20.30          Provider Deficiencies/Plan of Correction. 40

0300.20.35          Medicare Buy-in. 41

0300.20.40          Pharmacy Lock-In Program.. 41

0300.20.40.05       Enrollment in Pharmacy Lock-In Program.. 41

0300.20.40.10       REVS Identification of Lock-In Recipients. 42

0300.20.40.15       Primary Pharmacy of Choice. 42

0300.20.40.20       Primary Care Physician. 42

0300.20.40.25       Change in Primary Pharmacy/Physician. 42

0300.20.40.30       Change in Recipient Status. 43

0300.25             OVERVIEW OF MA ELIGIBILITY REQUIREMENTS. 43

0300.25.05          Technical Eligibility Requirements. 43

0300.25.10          Characteristic Eligibility Requirements. 43

0300.25.15          Cooperation Requirements. 44

0300.25.20          Financial Eligibility Requirements. 44

0300.25.20.05       Income Flex-Test and Spenddown. 44

0300.30             METHODOLOGY FOR DETERMINING COVERAGE GROUP. 44

0300.35             ORGANIZATION OF THE MANUAL. 45

0300.40             Procedure for Imposing Admin Sanctions. 46

0300.40.05          Statutory Authority. 46

0300.40.10          Definitions. 46

0300.40.15          Sanctionable Violations. 47

0300.40.20          Provider Sanctions. 49

0300.40.25          Notice of Violations and Sanctions. 49

0300.40.30          Informal Hearing. 50

0300.40.35          Administrative Hearing. 50

0300.40.40          Appeal for Judicial Review.. 50

0300.40.45          Administrative Actions. 50

0300.40.50          Stay of Order 51

0300.40.55          Reinstatement 51

0300.45             EXPEDITED SERVICES. 51

0300.45.05          EXPEDITED SERVICES PROVISION for H.C.B.S. 51

0300.45.10          HOME & COMMUNITY BASED SERVICES COVERED.. 53

0300.45.15          PROVISION FOR RECEIVING EXPEDITED SERVICES. 53

0300.45.20          REQUIREMENTS FOR REIMBURSEMENT. 55

0302                 THE APPLICATION PROCESS. 57

0302.05             THE REQUEST FOR MEDICAL ASSISTANCE. 57

0302.05.05          Request for a Medicare Part D Application. 58

0302.10             CONTENTS OF THE APPLICATION PACKET. 59

0302.10.05          Assistance in Completing the Application. 59

0302.10.10          Who Must Sign the Application. 60

0302.15             DECISION ON ELIGIBILITY.. 60

0302.20             PERIOD OF ELIGIBILITY.. 61

0302.25             CERTIFICATION OF ELIGIBILITY.. 62

0302.30             PAYMENT PROCESS. 63

0302.30.05          MA as Payor of Last Resort 63

0302.30.10          Direct Reimbursement to Recipients. 64

0304                 TECHNICAL ELIGIBILITY REQUIREMENTS. 67

0304.05             REQUIREMENTS OF CITIZENSHIP/ALIENAGE. 67

0304.05.05          The SAVE Program.. 68

0304.05.10          Eligibility as a United States Citizen. 69

0304.05.10.05       Verification of Citizen Status. 69

0304.05.15          Elig as a Qualified Non-Citizen. 73

0304.05.15.05       Five Year Ban. 75

0304.05.20          Eligibility as an Amerasian. 76

0304.05.20.05       Verification of Amerasian Status. 76

0304.05.21          Elig as a Lawful Permanent Resident (LPR) 77

0304.05.21.05       Verification of LPR Status. 78

0304.05.25          Elig as an Amer Indian Born Outside the US. 78

0304.05.25.05       Ver of Stat as Amer Ind Born Outside the US. 79

0304.05.30          Eligibility as a Conditional Entrant 79

0304.05.30.05       Verification of Conditional Entry. 79

0304.05.35          Eligibility as a Battered Non-Citizen. 80

0304.05.35.05       Verification - Battered Immigrant 80

0304.05.45          State-Funded Coverage Group Defined. 81

0304.05.45.05       Eligibility as a State Funded Non-Citizen. 82

0304.05.45.10       Verification of Lawfully Residing Status. 82

0304.05.45.15       Documentation of RI Residency Before 7/1/97. 84

0304.05.50          Eligibility as a Refugee. 85

0304.05.50.05       Verification of Refugee Status. 85

0304.05.55          Eligibility as an Asylee. 85

0304.05.55.05       Verification of Asylee Status. 86

0304.05.60          Eligibility as Deportation Withheld. 86

0304.05.60.05       Verification of Deportation Withheld. 86

0304.05.65          Eligibility as a Cuban/Haitian Entrant 86

0304.05.65.05       Verification of Cuban/Haitian Status. 87

0304.05.70          Elig as a Member of US Armed Forces/Veteran. 87

0304.05.70.05       Verification of Veteran/US Armed Forces. 87

0304.05.75          Eligibility as a Parolee. 88

0304.05.75.05       Verification of Parolee Status. 88

0304.05.80          Eligibility as an SSI Recipient 89

0304.05.85          Eligibility as a Victim of Trafficking. 89

0304.05.85.05       Verification of Victim of Trafficking Status. 89

0304.05.90          Sponsor Deeming. 89

0304.10             RESIDENCY REQUIREMENT. 92

0304.10.05          MA Residency Requirements. 92

0304.10.05.05       SSI Individual 92

0304.10.05.10       MA Families. 92

0304.10.05.15       MA Individual Over 21. 93

0304.10.05.20       MA Individual Under 21. 93

0304.10.05.25       Institutionalized MA Individual 93

0304.15             REQUIREMENT FOR SOCIAL SECURITY NUMBER.. 94

0306                 CHARACTERISTIC REQUIREMENTS. 94

0306.05             CHARACTERISTIC REQS FOR INDS & COUPLES. 94

0306.05.05          SSI-Related Age Requirement 95

0306.05.10          Eligibility Based on Blindness. 95

0306.05.15          Eligibility Based on Disability. 95

0306.10             CHARACT REQS FOR FAMILIES (AFDC-RELATED) 96

0306.10.05          Age Requirement 96

0306.10.10          Relationship Requirement 96

0306.10.15          Deprivation of Parental Support 97

0306.10.20          Exceptions to the Req of an AFDC Charact 98

0308                 COOPERATION REQUIREMENTS. 98

0308.05             APPLICANT REQUIRED TO COOPERATE. 98

0308.10             ASSIGNMENT OF RIGHTS. 98

0308.10.05          Coop in Est Paternity & Obtaining Support 99

0308.10.10          Coop in Identifying & Providing TPL Info. 99

0308.15             REQUIREMENT TO UTILIZE RESOURCES. 99

0308.15.05          Dist Office Procedures When Unavailable. 100

0308.20             APPLICANT'S PURSUIT OF OTHER BENEFITS. 101

0308.20.05          Availability of Other Program Benefits. 101

0308.20.10          Requirement to Pursue Other Benefits. 102

0308.20.15          Good Cause for Not Pursuing Other Benefits. 102

0310                 RETROACTIVE COVERAGE.. 103

0310.05             RETROACTIVE COVERAGE DEFINED.. 103

0310.10             ELIGIBILITY REQUIREMENTS. 104

0310.15             PROCEDURES FOR DETERMINING RETRO ELIGIBILITY.. 104

0310.20             AUTHORIZATION OF RETROACTIVE ELIGIBILITY.. 105

0312                 LIENS & RECOVERY OF MA PAYMENTS. 106

0312.05             LEGAL BASIS. 106

0312.10             APPLICATION OF THE LIEN.. 106

0312.15             EXCEPTIONS TO THE LIEN.. 107

0312.15.05          REDUCTIONS OF THE LIEN UNDER QLTCIP Program.. 107

0312.20             CLIENT NOTIFICATION.. 108

0312.25             PROCEDURES. 108

0312.30             RECOVERY.. 109

0312.35             DISCHARGE OF LIEN.. 110

0312.35.05          Request for Discharge Due to Inapplicability. 110

0312.40             UNDUE HARDSHIP CONSIDERATION.. 111

0312.40.05          Application for Undue Hardship Consideration. 112

0312.40.10          Undue Hardship Granted. 113

0312.40.15          Transfer/Sale of Property. 113

0314                 MA PAYMENT FOR OUT OF STATE CARE.. 113

0314.05             REQUIREMENT OF PRIOR AUTHORIZATION.. 113

0314.05.05          Exceptions to the Requirement of Prior Auth. 114

0314.05.10          Services Rendered to Temp Absent Recipients. 114

0314.05.15          Follow-up Procedures. 114

0316                 MEDICAL ASSISTANCE FOR ALIENS. 115

0316.05             IMPACT OF ALIEN STATUS ON SCOPE OF SERVICES. 115

0316.05.05          SAVE Requirement 116

0316.05.10          Refugee Medical Assistance. 116

0316.10             INELIG ALIENS RECEIVING RESTRICTED SERVICES. 116

0316.10.05          Restricted Services Eligibility Requirements. 116

0316.10.05.05       Restricted Services Eligibility Requirement 117

0316.10.05.10       Exception to SAVE Requirement 117

0316.10.05.15       Exception to Enumeration Requirement 117

0318                 MEDICAL ASSISTANCE REDETERMINATION.. 117

0318.05             REDETERMINATION OF MA ELIGIBILITY.. 117

0318.10             REDETERMINATION PROCESS. 118

0318.15             REDETERMINATION IN SHORT TERM FLEX TEST CASE. 119

0318.20             Redetermination of Disability Determination. 119

0320                 REFERRAL TO OTHER RESOURCES FOR MED CARE.. 124

0320.05             AVAILABILITY OF OTHER RESOURCES. 124

0320.10             REHABILITATION (ORS) SERVICES. 124

0320.10.05          VR Responsibilities. 124

0320.10.10          MA Responsibilities. 125

0320.10.15          Prior Authorization Required. 125

0320.10.20          Referral of MA Ineligible Indiv w/Disability. 126

0320.15             VETERANS BENEFITS. 126

0320.15.05          Who is a Veteran. 126

0320.15.10          Who is Eligible. 127

0320.15.15          Benefits Available. 127

0320.15.15.05       Death Benefits. 127

0320.15.15.10       Medical Benefits. 127

0320.15.15.15       Cost of Living Increases. 128

0320.15.20          How to Receive VA Benefits. 128

0320.20             RI PHARMACEUTICAL ASSIST FOR ELDERLY (RIPAE) 128

0320.20.05          Eligibility for Coverage. 128

0320.20.10          Covered Medications. 129

0320.20.15          Application Process. 129

0322                 EARLY INTERVENTION PROGRAM.. 129

0322                Early Intervention Program.. 129

0322.05             Purpose the the Early Intervention Program.. 129

0322.10             Definitions. 130

0322.15             Lead Agency. 133

0322.20             Interagency Coordinating Council (ICC) 133

0322.25             Certification Requirements. 136

0322.30             Eligible Population. 139

0322.35             Central Directory of Services. 139

0322.40             Comprehensive Child Find System.. 140

0322.45             Evaluation and Assessment Procedures. 141

0322.50             Individualized Family Service Plan (IFSP) 144

0322.55             Development, Review and Evaluation of IFSP. 145

0322.60             Transition of Children to Preschool Programs. 146

0322.65             Comprehensive System of Personnel Dev. 147

0322.70             Procedural Safeguards and Confidentiality 19. 149

0322.75             Mediation and Impartial Hearing Process. 154

0322.80             Resolving Complaints. 157

0322.85             Severability. 158

0326                 OVERVIEW OF MA.. 158

0326.05             MANUAL ORGANIZATION.. 158

0326.10             ELIGIBILITY REQUIREMENTS FOR FAMILIES. 159

0326.10.05          Family Categories - Eligibility Tests. 162

0326.15             COVERAGE GROUPS. 162

0328                 CHARACTERISTIC REQUIREMENTS. 164

0328.05             AGE REQUIREMENT. 164

0328.05.05          Verification of Age. 165

0328.10             RELATIONSHIP REQUIREMENT. 165

0328.10.05          Verification of Relationship. 166

0328.10.05.05       Verif Relationship Unwed Father 168

0328.10.10          Establishment of Home/Temporary Absence. 168

0328.15             DEPRIVATION OF PARENT SUPPORT. 169

0328.15.05          Deprivation, Continued Absence. 169

0328.15.05.05       Evidence of Parental Absence. 170

0328.15.05.10       Referral to Child Support 171

0328.15.10          Deprivation by Death. 171

0328.15.15          Deprivation, Phy/Mental Incap. 171

0328.15.15.05       Evidence of Parental Incapacity. 172

0328.15.15.10       Continuing Elig, Parental Incap. 172

0328.15.20          Deprivation by Parent Unemployment 173

0328.15.20.05       Definition of Unemployment 173

0328.20             EXCEPTIONS TO CHARACTERISTICS. 174

0328.20.05          Children Under 19. 174

0328.20.10          Pregnant Women. 175

0328.20.15          Section 1931 and MA Waiver Families. 175

0330                 INCOME GENERALLY. 176

0330.05             INCOME STANDARDS - FAMILIES. 176

0330.10             INCOME DEFINITIONS. 178

0330.15             DOCUMENTATION OF INCOME. 178

0330.20             EXCLUDED INCOME. 178

0330.25             EARNED INCOME. 180

0330.25.05          Earned Income From Wages. 180

0330.25.10          Earned Income From Self-Employment 180

0330.25.10.05       Payment for Providing Child Care Services. 181

0330.25.15          Earned Income From Roomer/Boarder 181

0330.25.20          Earned Income From Real Property. 182

0330.30             EARNED INCOME DISREGARDS. 182

0330.35             OTHER SOURCES OF INCOME. 183

0330.35.05          Fed/State Insurance, UCB, TDI 183

0330.35.05.05       Unemployment Compensation Benefits (UCB) 183

0330.35.05.10       Temporary Disability Insurance. 183

0330.35.10          Workforce Investment Act 184

0330.35.15          RSDI Income. 184

0330.35.15.05       Retirement Benefits. 185

0330.35.15.10       Survivorship Benefits. 185

0330.35.15.15       Lump Sum Death Benefits. 186

0330.35.15.20       Disability Benefits. 186

0330.35.15.25       Requesting Info from Social Sec. 187

0330.35.20          Employment Pensions. 187

0330.35.25          Veterans Administration Benefits. 187

0330.35.30          Workers' Compensation. 188

0330.35.35          Insurance Settlement 188

0330.35.40          Money/Goods From Other Agencies. 189

0330.35.45          Relative Contribution. 189

0330.35.50          Child Support Income. 189

0330.35.55          Inc for Ind Pursuing an Educ. 189

0330.35.55.05       Treatment of VA Educ Assis. 190

0330.35.55.10       Fed or Non-Fed Supported Source. 190

0330.35.60          Sponsor Deeming. 190

0332                 BUDGET PERIODS. 191

0332.05             DEFINITION OF A BUDGET PERIOD.. 191

0332.10             MEDICALLY NEEDY BUDGET PERIODS. 191

0334                 DETERMINING INCOME ELIGIBILITY. 192

0334.05             INTRODUCTION.. 192

0334.10             DEFINITIONS. 193

0334.10.05          Household Unit 193

0334.10.10          MA Applicant Unit 194

0334.10.15          Financial Unit 194

0334.15             GROUP SIZE AND COUNTABLE INCOME. 195

0334.20             STANDARD OF ELIGIBILITY.. 195

0336                 FLEXIBLE TEST OF INCOME.. 196

0336.05             USE OF EXCESS INCOME. 196

0336.05.05          When Eligibility Begins. 197

0336.05.10          Whose Expenses Are Used. 197

0336.10             DEDUCT LOANS TO PAY BILLS. 197

0336.15             DEDUCTING RECOGNIZED MEDICAL EXPENSES. 198

0336.15.05          Deducting Recognized Medical/Remedial Care. 199

0336.15.05.05       Adult Day Care. 199

0336.15.05.10       Respite Care. 199

0336.15.05.15       Home Health Aide/Homemaker Services. 200

0336.20             EXAMPLES. 200

0336.25             CERT OF FLEXIBLE TEST CASES. 201

0336.25.05          Controlling Flexible Test Cases. 202

0338                 RESOURCES GENERALLY. 202

0338.05             RESOURCE LIMITS. 202

0338.10             DEFINITION OF RESOURCE. 204

0338.10.05          Countable/Excluded Resources. 204

0338.15             DOCUMENTATION OF RESOURCES. 205

0338.20             TIMING OF RESOURCE EVALUATION.. 205

0338.25             EXCLUDED RESOURCES. 205

0338.25.05          The Home. 206

0338.25.10          Real Property Other Than Home. 206

0338.25.15          Income-Producing Property. 207

0338.25.20          Automobile. 208

0338.25.20.05       Special Use Vehicles. 208

0338.25.25          Burial Plot 209

0338.25.30          Funeral Agreement 209

0338.25.35          Resources Excluded by Law.. 209

0338.30             RESOURCE REDUCTION.. 210

0338.30.05          Date of Eligibility. 210

0338.30.10          Allowable Expenses. 211

0338.30.10.05       Guardian/Conservatorship Costs. 211

0338.30.10.10       Legal Fees. 212

0338.30.10.15       Tax Assessments. 212

0340                 EVALUATION OF RESOURCES. 212

0340.05             EVALUATION OF REAL PROPERTY..