VLP COA Codes Work Around

 

KEES implemented 10 COA codes that were added from the Department of Homeland Security. CMS created policy surrounding 8 COA codes that must meet the five-year bar if the applicants entered the United Stated after September 30th, 2023.

 

When an applicant reports they are one of the following:

The workaround must be applied in KEES.

  1. Navigate to the case.

  2. Navigate to Eligibility, then Customer Information.

  3. Navigate to the Non-Citizenship page and then click Edit.

  4. What the USCIS Document type is will determine the Section Code:

  5. USCIS Document is ‘Permanent Resident Card (“Green Card,” I-551)’

    1. Navigate to Section Code: and select the following from the dropdown:

      1. EC7

  6. USCIS Document is ‘Arrival/Departure Record (I-94, I-94A)’

    1. Navigate to Section Code and select the following from the dropdown:

      1. Public Interest Parolee

  7. Run EDBC for the first pending month.

    1. Ensure that the applicant’s Status Reason is Ineligible Non-Citizen.

  8. Accept EDBC results.

  9. Review the generated NOA for accuracy.

    1. Ensure the denial reason for the applicant matches the EDBC determination.

  10. Journal the actions taken.

    1. WA### was used to deny coverage for <applicant>.

The COA codes regarding NHP (Nicaraguan Humanitarian Parolee) and VHP (Venezuelan Humanitarian Parolee) must meet the five-year bar prior to receiving medical benefits. Workers must apply the work around in KEES.

  1. Navigate to the case.

  2. Navigate to Eligibility, then Customer Information.

  3. Navigate to the Non-Citizenship page and then click Edit.

  4. What the USCIS Document type is, will determine the Section Code:

  5. USCIS Document is ‘Permanent Resident Card (“Green Card,” I-551)’

    1. Navigate to Section Code and select the following from the dropdown:

      1. EC7

  6. USCIS Document is ‘Arrival/Departure Record (I-94, I-94A)’

    1. Navigate to Section Code and select the following from the dropdown:

      1. Public Interest Parolee

  7. Run EDBC for the first pending month.

    1. Ensure that the applicant’s Status Reason is Ineligible Non-Citizen.

  8. Accept EDBC results.

  9. Review the generated NOA for accuracy.

    1. Ensure the denial reason for the applicant matches the EDBC determine.

  10. Journal the actions taken.

    1. WA### was used to deny coverage for <applicant>.