Family Healthcare (FAMIS)

0910.050.15.10 ACTION NECESSARY FOR 6 MONTH CLOSINGS

IM-46 March 2, 2001IM-170 December 16, 2002

Prior to allowing the system to close a parent’s TMA eligibility at the end of the six (6) month limit for failure to comply with quarterly reporting, explore eligibility for other MC+/Medicaid categories.  If eligibility is established, use the IM-33MCC to notify the client of the change in eligibility.  If eligibility is not found as a result of the ex-parte review or there is insufficient information available to determine eligibility, allow the TMA case to convert to MC+ for Children at the end of the original six (6) month time limit.  Evaluate the children’s continued eligibility for MC+.  Make any changes in levels of care under the MC+ case effective the first of the following month.

The system generated IM-57 (TMA Closing Notice) notified the family that TMA coverage ended.

If the ex parte review indicates potential eligibility for another category of assistance, but eligibility cannot be established prior to the TMA ending, follow the procedures in Section 0910.050.20.10 to keep the TMA open.