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Issue Alert - 08-04-02

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Date:

Apr 03, 2008

Program Area:

Disability based Medicaid

Issue Summary:

Effective April 2008, DHS will have 90 days to process a Medicaid applications when the applicant’s disability is at issue

Persons Affected:

Applicants for Medicaid based on a disability

For More Information:

Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441 Fax: (989) 755-3558 E-mail: info@ccj-mi.org

Michigan Poverty Law Program 611 Church Street, Suite 4A Ann Arbor, MI 48104-3000 (734) 998-6100 (734) 998-9125 Fax


Background

Federal law states that state Medicaid agencies must approve or deny any Medicaid application within 90 days from the date of application when disability is at issue for eligibility purposes.  State agencies could set a shorter period of time or “standard of promptness” in their state plan.  In the past, Michigan Department of Human Services (DHS) had a 60 day standard of promptness for Medicaid applications when disability is at issue.  

What's Happening?

DHS has changed is Medicaid standard of promptness from 60 days to 90 days from the date of application when a disability determination is required for Medicaid eligibility, the maximum timeframe allowed by federal regulations.   The standards of promptness for applications are in DHS’s Program Administrative Manual Item 115, available online at http://www.mfia.state.mi.us/olmweb/ex/html/.

The standard of promptness for Medicaid applications when a disability determination is NOT needed is still 45 days.

The standard of promptness for State Disability Assistance (SDA) is still 60 days. 

What Should Advocates Do?

Inform clients of the changes in the length of time DHS has to process their Medicaid applications if DHS has to make a disability determination as part of their Medicaid eligibility.

Also, help clients monitor DHS’ timeliness.  If DHS takes longer than 90 days, help clients request a hearing to contest the delay.

What Should Clients Do?

Be aware that DHS has 90 days to process your Medicaid application if DHS has to decide if you are disabled for you to qualify for Medicaid.

Monitor how long it takes DHS to process your application.  If DHS takes longer than 90 days from the date the local DHS office received your application, you may want to request a hearing on the delay.  Contact your local legal aid or legal services office for advice and representation.  (See “Finding Legal Help”, below.)

Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.

You can locate various sources of legal and related services, including the free legal aid office that serves your county, at MichiganLegalAid.org.

You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.