NAME

WA NUMBER

PROGRAM

BRIEF DESCRIPTION

Grievance Task Is Not Closing When Contact Log Is Updated

415

ALL

RETIRED

Cuban Haitian Entrant Work Around 1.31.2024

448

ALL

RETIRED

PA Not Displaying as Casehead

492

ALL

RETIRED

RE Run Reason Validation without an Available RE Run Reason

508

ALL

RETIRED

Interest/Dividends/Investments not counting correctly in EDBC

589

ALL

RETIRED

WA 593 Ukraine Refugee / Afghan Evacuees Eligibility

593

ALL

RETIRED

LTC with MSP Pre-Tax deductions

598

ALL

RETIRED

Tier III TALX

501

ALL

MAGI-Budgeted Programs

RETIRED

VLP COA Codes Work Around WA677

 677

ALL

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, 2024.

Non-MAGI Children CE WA 675

675

ALL

RETIRED

SOBRA Children CE Work Around 01.12.2024 WA676

676

ALL

RETIRED

PMD Tier 1 With Income Under the SSI Limit Receive a Medically Needy Aid Code

221

E&D

RETIRED

TB Failing for EDBC Non-Citizens

404

E&D

RETIRED

Creating PMDT Tasks

537

E&D

RETIRED

Verify SSN Through the Federal Hub when Citizenship and ID is Verified or Exempt

561

E&D

RETIRED

Consumer receiving SSI Medical receives MSP/LMB in error

562

E&D

RETIRED

Health Insurance Premiums (any type) not being pulled into Medically Needy spenddowns

659

E&D

RETIRED

Secondary Motor Vehicle Not Counted in EDBC

661

E&D and LTC

RETIRED

May 2022 Release Medical EDBC Override for PHE

656

EDBC

RETIRED

Post-Partum CE Extension

660

EDBC

RETIRED

Medically Needy Spenddown Override for Shortened Spenddowns

663

EDBC

RETIRED

Cuban/Haitian Entrants

665

EDBC

RETIRED

DHS COA Codes

231451

EDBC

When workers encounter non-citizens with the following immigration statuses of PE1, PE2, or PE3, these individuals are eligible for medical coverage with a waiting period, unless they fall under a special group. As a reminder, staff would need to rely on VLP results to know if they were held to the 5-year bar or not and adjust eligibility as needed.

EDBC Override for Premium Delinquency

231466

EDBC

RETIRED

Baby Born to Mother Receiving Foster Care Medical

484

MAGI

When a minor mother gives birth to a child while receiving Foster Care Medical, that child needs to be authorized for Medicaid Deemed Newborn coverage on a new separate case number. KEES will not authorize coverage for the Deemed Newborn because the new case number has no adult caretakers on the case.

Filing Jointly with Spouse Outside the Home

496

MAGI

 If an applicant is filing jointly with a spouse, who is coded as Permanently Out of the Home, that spouse will be incorrectly included in the IBU of the applicant who they are filing jointly with. Policy states to add the spouse of an individual or tax filer, only if they are living together.

TransMed and Extended Medical

522

MAGI

RETIRED

Override the Primary Applicant When Only Child in Foster Care

534

MAGI

RETIRED

EDBC Not Determining PLN/PW for 18-Year-Old

535

MAGI

RETIRED

Incorrect IBU for 18-Year-Old Primary Applicant with Non-Filing Parent in the Home

536

MAGI

RETIRED

Child Receiving CTM in Error

550

MAGI

Currently there is a known issue where a child(ren) may receive CTM coverage in error. This may occur at the time of application. Children should only receive CTM coverage when there is a caretaker in the home who is actively receiving CTM Coverage.

This workaround should be used in situations when EDBC incorrectly issues CTM coverage to a child when there is no caretaker in the home receiving CTM.

Premium Billing Workaround674

674

MAGI

RETIRED

CSS Non-Coop with CTM WA678

678

MAGI

RETIRED

Baby born to incarcerated Medicaid Mother WA679

679

MAGI

If a baby is born to a mother who was approved for PLN/PW coverage, but then is incarcerated in the middle of her CE period, and the child is born while the mother is still incarcerated, that child is a deemed newborn. Per KFMAM 2052.07 incarceration disallows Medicaid payment of medical claims, it does not impact a person’s eligibility. This person will maintain eligibility for Medicaid while residing in a correctional facility and upon release may have benefits reinstated without a new application as long as they continue to meet categorical program requirements (age, residency, etc.).

For this Deemed Newborn coverage to be approved, an override is needed. Follow the steps in WA679  to approve the PLN/DN coverage for the child.

WA 237324 Premium Delinquency Workaround

237324

MAGI

CHIP-eligible children are being incorrectly denied at Reapplication.

TMD Given to PA Using a CH's Income – Defect KEES-237297 – WA237525

237525

MAGI

We are aware that the Primary Applicant is sometimes receiving TMD coverage due to the child’s income.

C-N-S941 Facility General Closure Form Effective Date Incorrect

489

LTC

RETIRED

CSRA Not Counting Resources

507

LTC

RETIRED

$20 Disregard for LTC Consumers

554

LTC

RETIRED

PACE EDBC Override for current or previous months

584

LTC

Currently EDBC will fail when running a current or previous month. If a late change is needed, EDBC will need to be overridden.

Exempt Income Subtracted from Share of Cost

623

LTC

RETIRED

Tier III - TALX

498

MAGI

RETIRED

Determine TMD When CTM Continued Past CE Date

587

MAGI

At review, if applicants have active CTM benefits that exceed the CE Date and an increase in earned income that places them over CTM guidelines, EDBC will not determine TMD when running EDBC in the soonest unpaid month.

Premium Delinquency WA 237234

237234

MAGI

RETIRED

Invalid RMT Combo for PPS-AGO

655

PPS

RETIRED

Working Healthy Recipient Request To Add WORK/WORK Case Maintenance

615

WORK

RETIRED