Family Healthcare (FAMIS) Manual

0910.050.10 SUSPENDED TMA ELIGIBILITY

An ex parte review should be completed to evaluate possible eligibility under other programs.

Caretakers (age 19 and over) who fail to comply with the second and third quarterly report are suspended effective the first of the following month.  The individual status of the adult caretaker(s) will change to a “S” level of care with a “S” (suspended) in field 13g2.  The case will remain active in the system as a TMA case.  If the children are on the TMA case, they will continue to be shown as a “T” level of care.

Review the children’s continued eligibility for MC+/Medicaid based on the information on file.  Do this by registering a separate MC+ application and evaluating the children’s eligibility under MC+ for the appropriate level of care.  The level of care for the children should be changed to a Z (included) on the TMA case, to enable you to approve the MC+ case.  If ineligible for reinstatement to the TMA, the TMA should remain in the system with suspended individuals until the system closes it at the end of twelve-month TMA eligibility period.

If there are children on the TMA case at the end of the twelve-month TMA eligibility period, the case will convert to MC+ for Children.

If there are NO children active on the TMA case the case will be closed by the system at the end of the twelve-month eligibility period.