• The SPECIAL INITIAL INVOICE (see attachment), will bill the client for the premium(s) for the month(s) prior to and including December 2002.

• The SPECIAL RECURRING INVOICE (see attachment) for January 2003 will notify the client that if payment is not received by 12/31/02 they will not have coverage for January 2003.

• The INITIAL INVOICE (see attachment) for all months through the month following the month of approval.

• The RECURRING INVOICE (see attachment) sent on the second working day of each month for the next month's premium.

• The FINAL RECURRING INVOICE (see attachment) sent after the client has not paid for three consecutive months.  It is sent in place of the RECURRING INVOICE on the second working day of the month for the next month's premium.  It notifies the client that the case will be closed if a payment is not received by the end of the month. 

Example:  Client is approved for premium coverage on 2/15/03 with a Title XIX begin date of 10/1/02.  On 2/16 they are sent an Initial Invoice for Oct. through Mar, but do not pay for Mar.  On 3/1 and 4/1 they are sent Recurring Invoices, but send no payment for either month.  On 5/1 they will be sent a Final Recurring Invoice for June.  If by 5/31/02 they have not paid for any of the months Mar. through June, the case will close.

The MSPI screen will show coverage dates based on premium payment.  It is the same screen used for MA Spenddown coverage date.  The PGM (Program) field will show MAWD or SPND to differentiate between MA-WD and MA Spenddown.  Under the column METHOD, the MA-WD premium clients approved prior to 12/1/02 will show coverage for the months they were in the Premium Group prior to December 1, 2002, and through December 31, 2002, as TRANS.  These clients have coverage for those months even if the premium is not paid.  Clients approved in the premium after November 30, 2002 will only have coverage for the months their premium is paid.

Beginning December 2, 2002 send the revised IM-32MA-WD (attached) on all new MA-WD premium approvals.  When a MA-WD case changes from non-premium group to premium group send an IM-80.  Follow regular adverse action and hearing procedures.  Once the adverse action is taken, send the revised IM-32 MA-WD.

MA-WD clients will have the option of paying the premium by automatic withdrawal.  Clients will be given the option of filing a form for DMS to have their premium amount withdrawn from an existing bank account.  Withdrawals will be made on the 15th of each month. The effective date for automatic withdrawals for MA-WD premiums (and spenddown pay-ins) depends on the day the form is received by DMS and when the Financial Institutions put the withdrawal in place as to when the premium is paid by automatic withdrawal. Therefore clients must send a check or money order to pay for the prior, current and possibly the month after sending in the form. The client will receive a monthly confirmation of withdrawal from DMS (see attachment).  If a problem with the withdrawal occurs, DMS will send a letter informing the client that their Automatic Withdrawal was returned (see attachment).  Reasons for the return and instructions on how to resume or correct the problem are included in the letter.

• Review this memorandum with appropriate staff.

 
• Begin using the revised IM-32MA-WD for premium group approvals in December.