*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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Effective: June 1, 2011 |
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29.20.10 - Processing PARIS Matches |
Archived: June 1, 2016 (Previous Version) |
Follow these steps upon receipt of a PARIS match:
Note: Specific system instructions are available in POLI Temp at TE02.08.181.
Step 1: Review the case record to determine if the matched person is still active on this case.
l If the matched person is not active on this case, go to step 2.
l If the matched person is active on this case, go to step 4.
Step 2: Determine if the matched person is in another active or pending household in Minnesota.
l If the matched person is not a member of another Minnesota Health Care Programs (MHCP) household, go to step 3.
l If the matched person is not a member of another cash, Food Support (FS) or Child Care Assistance Program (CCAP) household:
n Document the PARIS match resolution in case notes. Start the case note with the word ”PARIS” for easy identification.
n Update the PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
l If the matched person is a member of another active or pending MHCP, cash, FS or CCAP household, go to step 4.
Step 3: For people enrolled in health care only, determine if the matched person deems to another active or pending enrollee.
l If the matched person does not deem to another active or pending MHCP enrollee:
n Document PARIS match resolution in case notes. Start the case note with the word ”PARIS” for easy identification.
n Update PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
n No further action needed.
l If the matched person deems to another active or pending MHCP enrollee, go to step 4.
Step 4: Review the case record to determine if the match information has already been resolved or is explained by information in the case file.
l If PARIS information is consistent with information in the case file:
n Document PARIS match resolution in case notes. Start the case note with the word ”PARIS” for easy identification.
n Update the PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
n No further action needed.
l If PARIS information is inconsistent with information in the case file, go to step 5.
Step 5: Send the appropriate PARIS Interstate Match Notice to person 01 on the case:
l For Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) cases, code MAXIS to send the system-generated PARIS Interstate Match Notice for each person matched.
l For MinnesotaCare cases print and send the Request for Proof of Residence (DHS-6035).
Allow the household 10 days to respond. The timeline may be extended if a household is cooperating with obtaining proof of residency.
n If the household submits requested proof of residency for matched person(s), go to step 6.
n If the household confirms all household members have left Minnesota, go to step 7.
n If the household confirms the matched member is no longer part of the household, go to step 8.
n If there is no response to the PARIS Interstate Match Notice, go to step 9.
Note: See Determining Residency Following a PARIS Match for information on acceptable proofs.
Step 6: Upon receipt of proof of residency:
l Document receipt of proof of Minnesota residency in case notes. Start the case note with the word ”PARIS” to identify that it is due to a PARIS match.
l Determine if proof received verifies Minnesota residency.
n If proof received is inadequate, repeat step 5.
n If proof verifies Minnesota residency:
m If the client is active or affects another person’s eligibility in any other public assistance case, advise the worker on other case(s) of receipt of proof of residency.
m Update PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
m Update other panels as appropriate.
Step 7: Upon confirmation that all household members have left Minnesota:
l Document PARIS match resolution in case notes. Start the case note with the word ”PARIS” for easy identification.
Note: Verbal confirmation is acceptable. No verification required.
l Close eligibility for the household giving proper notice.
l Determine overpayments as appropriate.
n If the client is active or affects eligibility on any other public assistance case, advise the worker on other case(s) of information received.
n Update PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
Step 8: Upon confirmation that the matched member has left the household:
l Document PARIS match resolution in case notes. Start the case note with the word ”PARIS” for easy identification.
Note: Verbal confirmation is acceptable. No verification required.
l Remove matched member from the household with 10 day notice.
l Redetermine eligibility for the remaining members of the household per program policy.
l Determine overpayments or refer to fraud as appropriate for the affected program(s).
n If the client is active or affects eligibility on any other public assistance case, advise the worker on other case(s) of information received.
n Update PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
Step 9: If there is no response to the PARIS Match Notice and proof of residency is not received within 10 days:
l Document in case notes that no response has been received. Start the case note with the word ”PARIS” for easy identification.
l Close the case for the appropriate reason allowing 10 day notice.
l For Health Care Programs, close eligibility for non-matched household members or others if the matched person is counted in their household, unless they meet an exception.
n If the client is active or affects eligibility on any other public assistance case, advise the worker on other case(s) of information received.
n Update PARIS match resolution status in MAXIS for Medical Assistance (MA), Emergency Medical Assistance (EMA), Medical Assistance for Employed Persons with Disabilities (MA-EPD), and Medicare Savings Programs (MSP) enrollees.
Exception: Do not close MHCP eligibility for non-matched enrollee household members who are auto newborns, pregnant women, 1619(a) or 1619(b) recipients, enrolled in the Medicare buy-in, or enrolled in a Medicare Savings Program. These may only be closed for no response if they are matched in the PARIS Interstate Match.