Family Healthcare (FAMIS) Manual – Table of Contents

0910.045.05 Change Not Reported Timely (TMA)

  1. When the change causing MAF ineligibility is reported or discovered prior to payroll closing in what would be the third month of Transitional Medical Assistance eligibility, use the same procedures outlined previously.
  2. When the change is reported/discovered after payroll closing of the third month but before the 21st day of the fourth month of Transitional Medical Assistance eligibility, use MAF closing procedures to transfer the case to Transitional Medical Assistance. Additionally, give or send the caretaker the quarterly report form.
  3. When the change is reported/discovered after the 21st day of the fourth month but before the end of the sixth month of Transitional Medical Assistance eligibility, complete a closing transaction providing Transitional Medical Assistance for the first six months only. DO NOT give or send the caretaker a quarterly report form. The due date passed and the caretaker cannot be eligible for the second six months. Explore eligibility for other MC+ healthcare programs.
  4. When the change is reported/discovered after the end of the sixth month of Transitional Medical Assistance eligibility, close the MAF case and do not transfer to Transitional Medical Assistance. Explore eligibility for other MC+ healthcare programs prior to closing the MAF case. Complete a claim for MC+ healthcare benefits received for any month after the sixth month unless other eligibility exists.