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Effective: June 1, 2010 |
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29.20.10ar1 - Processing PARIS Matches (Archive) |
Archived: June 1, 2011 |
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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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), Medicare Savings Programs (MSP), and GAMC 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.