Family Healthcare (FAMIS)

0910.025.00 QUARTERLY REPORT REQUIREMENTS (TMA)

IM-59 April 25, 2003

In the third, sixth, and ninth months of Transitional Medical Assistance eligibility, Transitional Medical Assistance quarterly reports are sent to caretakers.  To continue eligibility, a quarterly report form must be completed and returned in the fourth, seventh, and tenth months respectively, by the 21st day of those months.  Failure to return the first quarterly report by the due date results in ineligibility for the second six months, unless good cause exists.  Failure to return the second or third quarterly reports by the due date results in suspension of the caretaker’s TMA eligibility until the completed report is submitted.  The parents are not eligible for TMA during the suspension period unless good cause for failure to report exists.

For the first quarterly report, if the claimant fails to return a completed report by the 12th of the month, a reminder notice is sent to the claimant.  This notice provides no specific information, but instructs the claimant to contact the caseworker if he/she already submitted the report form to ensure the report was received or to investigate why it is incomplete.  For the second or third quarterly report, if the claimant fails to submit the completed report by payroll closing of the seventh or tenth month, caretakers are suspended.  If payroll closing is prior to the 21st of the month, and the claimant submits a completed report after payroll closing but by the 21st of the month, reinstate the caretaker’s eligibility.

When the quarterly report is received, determine if the report is complete, and determine if the family continues to meet Transitional Medical Assistance eligibility requirements.

FIM31412 Parent Losing Eligibility for TMA lists TMA cases where parent lost eligibility by either suspending or converting to MC+ for Children at the end of six or twelve month.