2006 Memorandums
IM-26      02/28/06




Effective immediately, staff must explore MPW eligibility for women age 19 or over who apply for MAF. Senate Bill 539 (2005) eliminated certain Medicaid services for all adults with the exception of blind individuals, nursing facility residents, children and pregnant women. These services include the following:

The Family Support Division's policy is to provide access to the best Medicaid coverage available to a client. Previously, a woman determined eligible for both MAF and MPW was approved for Medicaid coverage under the MAF program, as it is not time-limited and provided the same range of Medicaid services. Women could then be moved from MAF to MPW if an income change caused MAF ineligibility. The changes noted above have now made MPW the best Medicaid coverage available for a woman eligible for both MAF and MPW.

Application Process

Explore eligibility for MPW for female adult assistance group members applying for MAF. Applicants who state they are pregnant must have an MPW application registered. If the applicant states she is pregnant, inform her that if she verifies the pregnancy, she would have access to additional Medicaid services, if eligible.

Applicants dually eligible are to be approved for MPW and are to be included (“Z” level of care) on the MAF case. Reject MPW applications if verification of pregnancy is not provided.

Do not delay approval of MAF if:

If pregnancy is verified after the client has been placed on MAF, move the client to MPW when the information is received to ensure she has access to the most beneficial service package.

Reinvestigation Process

If a reinvestigation or other contact with a MAF recipient indicates that an adult assistance group member is pregnant, explore MPW eligibility. Register a MPW application immediately and explore eligibility factors. If a recipient is determined eligible for MPW, approve the MPW application and change the recipient's MAF status to included (“Z” level of care).

Termination of Pregnancy

Once the 60-day post-partum period ends for recipients of MPW, explore eligibility for MAF. Individuals who remain as included on an active MAF case (or an MAF case that has become TMA) must have their level of care changed to “T” on the MAF assistance group beginning the first of the month following the 60-day post-partum period.

Individual's not included on an active MAF case (or TMA, if applicable) and who are otherwise not eligible for MAF must remain active on the MPW case. The system will transfer uninsured MPW recipients to the Extended Women's Health program (EWHS).



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