Issue Alert - 08-04-03
Document Actions
| Date: | 04/07/2008 | |
| Program Area: | Medicaid (MA) |
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| Issue Summary: |
Medicaid applicants and recipients will only be given a single extension of time for providing requested verifications, even if they are making a good faith effort to get the requested items and even if they request additional time |
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| Persons Affected: | Medicaid applicants or recipients who have difficulty obtaining requested verification within 20 days of the original request |
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| For More Information: |
Medicaid applicants or recipients who have difficulty obtaining requested verification within 20 days of the original request
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Background
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Prior to April 1, 2008, the Michigan Department of Human Services (DHS)
used the same policy on timeliness of verification for all programs. Under that policy, clients were given 10 days
(or the time specified in other policy sections) to submit requested verifications
and the DHS caseworker could extend the time if the individual was unable to
provide it despite a reasonable effort to do so. Caseworkers were required to provide AT
LEAST one extension of time to clients who were making reasonable efforts.
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| What's Happening? | ||
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Effective April 1, 2008, the
verification policy for MEDICAID applicants and recipients has been changed.
DHS will no longer allow the caseworker to grant more than one extension of
time. Caseworkers may extend the time NO
MORE THAN ONCE. DHS Program
Administrative Manual (PAM) Item 130 p. 4.
DHS policy manuals are online at http://www.mfia.state.mi.us/olmweb/ex/html/. Verification policy for programs
OTHER THAN MEDICAID have not been changed and caseworkers may extend the time
for those programs more than once. THE POLICY ITSELF DOES NOT LIMIT
THE LENGTH OF THE ONE-TIME-ONLY EXTENSION granted for Medicaid
verifications. Therefore, advocates
should request an extension that will give the client or advocate enough time
to submit the verification before the deadline.
However, be aware that analysts from the Department of Community Health
have indicated the extension cannot be for more than 10 days. REQUIRED VERIFICATION (PEM 130 p. 2-3) For most eligibility factors, when documentary
verification is unavailable, the caseworker can verify the factor through a
collateral contact (i.e. phone contact).
If no verification is available, the caseworker can use the best
available information or his/her own best judgment. However, the following factors MUST be
verified through documentation: ·
Alien
status for non-citizens (unless seeking only Emergency Services Medicaid or
benefits for other family members) ·
Disability,
blindness, or incapacity ·
Lack
of capacity to declare residency ·
Pregnancy
(only for FIP) In addition, for POLICY EXCEPTIONS |
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What Should Advocates Do?
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1. Help clients ask for adequate extensions of
time for submitting verification. 2. Help
clients request help from DHS in obtaining verification if they will not be
able to get the verification themselves within the time allowed. Help clients document their requests for
help. 3.
Share your experiences with this policy. The Center for Civil Justice is interested
in hearing from advocates regarding problems experienced by clients because of
this new policy so we can inform policy makers about the impact of the policy
on Medicaid applicants. |
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What Should Clients Do?
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1.
Ask for help from DHS right away if you have trouble getting
verifications for DHS. Put it in writing
and keep a copy. 3.
Seek legal advice if DHS will not help with verifications or your
benefits are denied, reduced, or terminated. See “Finding Legal Help” below. |
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Finding Help
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Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.
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Free SBM Workshop on Legal Issues Concerning LGBT Clients with ACLU
