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Effective: July 1, 2009 |
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19.20.05ar2 - MA Asset Verification Denial/Closure (Archive) |
Archived: June 1, 2011 |
People denied or closed from MA due to failure to verify assets may not be eligible for MinnesotaCare or GAMC. Follow program provisions provided in this section.
Adults without children are not eligible for MinnesotaCare if they meet all of the following criteria:
l They were denied or closed from MA.
l The MA denial or closure occurred on or after July 1, 2006.
l The denial or closure was based solely on the client’s failure to provide asset verification.
Note: Eligibility for MinnesotaCare may be determined if the denial or closure was due to more than just the failure to verify assets.
Deny or close MinnesotaCare eligibility for people meeting this criteria.
Do not forward the application or renewal to MCRE Operations or determine MinnesotaCare eligibility.
l Use MMIS code ”25” to deny or cancel eligibility.
l Complete and send a MinnesotaCare Explanation of Denial or Cancellation (DHS-4856).
Example:
Johan applied for MA on August 15, 2006. He is disabled but is not yet eligible to receive Medicare. Johan fails to provide verification of one checking account, but provides all other required information and verification. His application for MA is denied.
Action:
Johan’s application will not be forwarded for a MinnesotaCare eligibility determination.
Example:
Trish is single and applies for MinnesotaCare on October 17, 2006.
Action:
Determine if Trish was denied or cancelled from MA on or after July 1, 2006 solely for failure to verify assets.
Trish’s MA-EPD enrollment was closed on July 31, 2006 for failure to verify assets at renewal.
Action:
Trish is ineligible for MinnesotaCare because she is an adult without a child, her MA closed after July 1, 2006 solely for failure to verify assets.
n Deny MinnesotaCare eligibility with MMIS code ”25.”
n Complete and send the DHS-4856.
Example:
Jacob is single and applies for MinnesotaCare on October 23, 2006. His MA eligibility was closed August 31, 2006 at his last renewal for failure to verify income and assets.
Action:
Process MinnesotaCare eligibility. Although Jacob’s MA eligibility was closed after July 1, 2006, and he is an adult without a child, the closure was based on other factors than just failure to verify assets.
Clients who have a basis of eligibility for MA are not eligible for GAMC. Clients are not eligible for GAMC if they meet all of the following criteria:
l They were denied or closed from MA.
l They continue to have an MA basis of eligibility.
l The MA denial or closure occurred on or after September 1, 2006.
l The denial or closure was based solely on the client’s failure to provide asset verification.
Note: If the denial or closure was due to more than just the failure to verify assets, eligibility for GAMC must be determined.
Example:
Sylvester is disabled and applies for MA/GAMC on July 10, 2006. He does not provide asset verification and his MA application is denied.
Action:
Sylvester has a basis of eligibility for MA and is not eligible for GAMC.
Note: If Sylvester did not have an MA basis of eligibility, a GAMC determination must be completed.
Example:
Nikki applies for GAMC on November 12, 2006. Her MA was closed at renewal on September 30, 2006 for failure to provide asset verification. Since the closure Nikki’s children have left her household and she now lives alone.
Action:
Determine GAMC eligibility following GAMC asset rules. Nikki no longer has a basis of eligibility for MA.