Sometimes the consumer is eligible for QMB in the application month/month of processing. When this happens the process in KEES is slightly different. Please check the KEESM manual for examples of when a consumer may be eligible for QMB in the application month and/or month of processing.
Data: Enter all appropriate/relevant information.
Navigate to the Other Program Assistance page.
Click the Add button to add a new record.
Select the name of the consumer receiving QMB from the Name drop-down menu.
Select Medicare Savings Program from the Type of Assistance drop-down menu.
Select KS from the State drop-down menu.
Select QMB from the MSP Type drop-down menu.
In the Begin Date field, enter the first day of the month prior to the month the consumer will be eligible for QMB.
In the End Date field, enter the last day of the month prior to the month the consumer will be eligible for QMB.
Select Verified under the Medical Verified drop-down menu.
Run EDBC for the month the consumer is eligible for QMB.
From the Medical EDBC Summary page, review the Eligible Budget listed to ensure the appropriate QMB budget is listed.
Click the Accept button.
Click Save and Continue on EDBC List page.
Run EDBC for the month following the processing month (through the come-up month). QMB is approved using EDBC rules.
Send appropriate NOAs for the Medicare Savings Program.
Record a Journal entry.
NOTE: This is also the process to approve the first month of QMB for an ongoing Medicaid recipient.
NOTE: These instructions pertain to approving QMB in the month of application/processing only. They should not be used to approve QMB for prior medical months. Staff should not be approving QMB in prior medical months for a new application.
If a review form is received timely but has to be pended for additional information which isn't returned timely, thereby creating a gap in QMB eligibility (and the individual is otherwise eligible), the following process should be used.
NOTE: Prior Medical should be assumed in this scenario, however it should NOT be registered as Prior Medical. .
Click the View Details button in the appropriate Medical program block. The Medical Detail page displays.
Click the Edit button to make the page editable.
Click the Edit button for the Application Date in the Program Information block. The Application Detail page displays.
If a new Program Application was registered, proceed to Step 4.
If only a new Person Application was registered, skip to Step 5.
Change the Program Application Date to be the 1st day of the month when QMB needs to start (DO NOT use the Tab key to exit the field, simply click out of it.
Change the Application Date and the Beginning Date of Aid (BDA) for the QMB program person to be the 1st day of the month when QMB needs to stars.
NOTE: Do not change the Application Date or BDA for any other non-QMB program persons.
Select Administrative Decision from the Change Reason dropdown menu at the top of the page.
Click the Save and Return button. The Medical Program Detail page displays.
Click the Save and Return button. The Case Summary page displays.
If a new Program Application was registered, then the Administrative Role Detail page for the Primary Applicant will need to updated to the 1st day of the month when QMB is starting.
If only a new Person Application was registered, no update is needed.
Update the RMT for the QMB program person to be the 1st day of the month when QMB is starting.
Add an OPA record using the instructions above.
Run EDBC through the come-up month.