Following the implementation of new policies and procedures in the Family Medical program, follow up guidance has been issued by the Health Care Financing Administration (HCFA) in regards to the process of transferring assistance to a new county. This recent transmittal clarifies that federal regulations specifically prohibit action that requires the family to reapply for Medicaid or comply with a Medicaid redetermination solely based upon a move to a new county. The procedures outlined in this memo are being implemented as a result of this guidance to ensure federal compliance. They are effective upon the receipt of this memo and are applicable to any inter-county transfer processed on or after this date.

KEESM 9621 currently requires that the review period for most Medicaid programs be shortened when a family moves to a new county. This minimally requires the family to submit a new application for continuing Medicaid coverage and, in some instances, results in termination if the family fails to comply. This policy was applied to all Medicaid recipients except those in long term care arrangements, SSI recipients and children or pregnant women eligible under the poverty level programs. Although this has been standard practice in these programs for some time, the change from using an MP program to an MA CM program to provide protected medical coverage for TAF recipients, which was implemented on 01-01-01, made it difficult to ensure continuous eligibility for children in inter-county transfer situations.

The following procedures are applicable to the medical programs when transferring assistance to a new county. The current process outlined in 9222 (2) shall continue to be followed for transfers to and from the HealthWave Clearinghouse. The current process also remains in effect for transferring other programs.

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The sending county is responsible for the following actions:

1. Update address information on KAECSES.

2. Update KAECSES with the known changes and adjust eligibility. Exception: MA CM eligibility shall not be adjusted based on any change in the cash need standard because of a new shelter standard applicable in the new county at this time.

3. Regardless of other program involvement, the medical review period for any open Medicaid or HealthWave program shall NOT be shortened.

4. Reauthorize the last paid medical benefit month to ensure proper managed care assignment in the new county.

5. For MS AC or CI programs, obtain an MS-2126 from the new facility, current CARE information (if necessary) and update LOTC.

6. For HCBS programs, an MS-3161 shall be sent to the HCBS Case Manager or Independent Living Counselor notifying them of the new address. This is not necessary if the case manager has already initiated an MS-3161 to the EESS regarding the change of address.

7. A worker alert shall be set for the receiving county by the sending county. The alert message should read "ICT Completed-Check Medical" with a due date of the 15^th of the month following the month the transfer is reported, or the month of any shortened review for another program if applicable. This will allow the receiving county to check eligibility and allow time to make any necessary adjustments in eligibility.

8. Send a notice of action informing the client the case has been transferred and any changes in eligibility, including an appropriate facility notice when applicable.

9. Transfer both the paper file and the electronic file.

The receiving county shall assume the following responsibilities:

1. For HCBS programs, send an MS-3161 to the new case manager, or agency, requesting a status update to ensure services are continuing in the new county and to obtain cost of care information. This is not necessary if the case manager has already sent an MS-3161 to the EESS.

2. For MA CM programs, adjust eligibility based upon the new shelter standard for the county. Other changes that have been reported shall also be acted upon at this time. Any resulting eligibility adjustments are effective no later than two months following the month of transfer.

These changes will be incorporated into the KEESM in the future. The KAECSES User Manual will also be updated with new procedures reflecting this change.

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This page was last updated:  September 23, 2004