IM-73 06/26/98 QUARTERLY REAPPLICATION FOR MA SPENDDOWN
|QUARTERLY REAPPLICATION FOR MEDICAL ASSISTANCE
FORMS MANUAL REVISION #18: IM-2SPDN FORM AND FORM INSTRUCTIONS
|The current Medical Assistance spenddown
reapplication process is burdensome to customers and staff. To streamline
the reapplication process and accelerate the approval of spenddown reapplications,
the following changes have been made:
This process does not represent any changes in eligibility requirements. It is still necessary to advise the customer of their spenddown amount (IM31SPDN) and verify medical expenses incurred during the spenddown quarter. An interview is not required.
Record new information or changes on the most recent IM-38. Customers may report varying amounts in their bank accounts. If a reported change is not above the resource maximum, it is not necessary to reverify. This process should facilitate immediate approval of spenddown reapplications upon verification of changes and medical expenses.
The annual reinvestigation will begin at reapplication in the 5th quarter. Use the following methods to assist in the reinvestigation process:
Conduct re-evaluations of disability determinations when they are due. Follow procedures currently in place for re-evaluations by MRT. If eligible on all other factors, a customer remains eligible until a MRT determination finds they are no longer disabled.
Timely reapplication and approval of benefits for Medical Assistance spenddown simplifies the process for both customer and worker, and provides efficient service delivery. County office's are encouraged to develop a procedure to initiate spenddown reapplications by mail.
Some counties utilize the List of Daily Transactions (FIM31049), a report received by the supervisors. On payroll closing at the end of the 3rd month, the system electronically closes spenddown cases. The day after payroll closing the system generates the Daily Transactions Report over the print subsystem (S020) and lists by load number, all spenddown cases that closed. This tool prompts the worker to generate an IM2SPDN to the customer. A sample of this report is attached to this memorandum.
Agencies working with spenddown customers may want to have the IM2SPDN form available at their sites. Make these forms available to them upon request.
If the following circumstances occur, use the guidelines listed below: