Department of Human Services Index: MAN3480 Online ...

VOLUME II/MA, MT 64 06/21 TOC-1

SUBJECT: Administration of the Medicaid Program

MEDICAID MANUAL TABLE OF CONTENTS

Chapter Section Subject

2000 GENERAL MEDICAID INFORMATION

2000

General Program Overview

2001 Computer Matches Overview

2002 Income and Eligibility Verification System

2003

Internal Revenue Service (IRS) and Beneficiary Earnings Exchange Records System (BEERS) Information System

2004 Clearinghouse

2005 SSN Validation

2010 Confidentiality

2011 Health Information Portability and Accountability Act of 1996

2015

Mandated Reporting

2020 Americans with Disabilities Act/Section 504

2025

Civil Rights

Department of Human Services Online Directives Information System

Index:

Revised: Next Review:

MAN3480 06/01/2021 06/01/2023

http://odis.dhs.state.ga.us/ViewDocument.aspx?docId=4001285&verId=1



























2050

APPLICATION PROCESSING

2050 Application Processing Overview

2051 Verification

2052

Continuing Medicaid Determination

2053 Retroactive Medicaid

2054 Emergency Medicaid Assistance

2055 Sponsored Aliens

2060

ABD Medicaid Application Processing

2065 Family Medicaid Application Processing

2066

Placement Outside of the Home (Family Medicaid)

2067 Presumptive Medicaid (Family Medicaid)

2068 Special Considerations

2100

CLASSES OF ASSISTANCE

2101 ABD Medicaid Classes of Assistance Overview

2111

Supplemental Security Income (SSI) Medicaid

2113 Pickle (Public Law 94-566)

2115

Disabled Adult Child (Public Law 99-643)

2116 Former SSI-Disabled Child

2117

Disabled Widow(er)

2119

Disabled Widow(er) Age 60-64 (Public Law 100-203)

2121 Widow(er) 1984 (Public Law 92-272)

2123 Protected Medicaid 1972 (Public Law 92-603)












































2131

Community Care Services Program

2132

New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP)

2133 TEFRA/Katie Beckett

2135 Hospice Care

2136 Institutionalized Hospice

2137 Hospital

2139

Independent Care Waiver Program

2141 Nursing Home

2143 Qualified Medicare Beneficiaries

2144

Specified Low-Income Medicare Beneficiaries

2145 Qualifying Individuals - 1

2146

Low Income Subsidy (Extra Help for Medicare Part D)

2147 Qualified Disabled Working Individuals

2149 Georgia Medicaid for Workers with Disabilities

2150 ABD Medically Needy

2160

Family Medicaid Overview

2162

Parent/Caretaker with Children

2166 Transitional Medical Assistance

2170

Four Months Extended Medicaid

2174 Newborn Medicaid












































Chapter Section Subject 2100 (cont.)

2182

Children Under 19 Years of Age

2184 Pregnant Women

2186 Planning for Healthy Babies (P4HB)

2194 Peachcare for Kids

2196

Family Medicaid Medically Needy

2198 Women’s Health Medicaid

2200

BASIC ELIGIBILITY CRITERIA

2201 Overview

2205 Aged, Blind, Disabled Requirement

2210 Application for Other Benefits

2215

Citizenship/Immigration/Identity

2220 Enumeration

2225 Residency

2230 Third Party Liability

2235

Length of Stay

2240 Level of Care

2245 Living with a Specified Relative/Tax Filer/Non Tax Filer

Status

2250 Child Support Services

2255 Age (Family Medicaid)

2300

RESOURCES

2300 ABD Medicaid Resources Overview

2301 Family Medicaid Resources Overview













































2300 (cont.) 2302 Ownership of Resources in ABD Medicaid

2303 Determining the Countable Value of Resources for

ABD 2304 Treatment of Resources for ABD

2305 Co-Mingled Funds

2306 Agent Orange

2307 Austrian Social Insurance Payments

2308 Vehicles

2309 Bonds - Municipal, Corporate, Government

2310 Bonds - U.S. Savings

2311 Burial Contracts (Pre-Paid or Pre-Need) and Burial

Space Items

2312 Burial Funds

2313

Contracts - Promissory Notes, Loans and Property Agreements

2314 Disaster Assistance

2315 Dividends, Accrued

2316 Homeplace: ABD Medicaid

2317 Homeplace: Family Medicaid

2318 Home Replacement Funds

2319

Household Goods and Personal Effects

2320

Inheritances and Unprobated Estates

2321

Japanese American and Aleutian Restitution Payments

2322 Life Estate and Remainder Interests



















































2300 (cont.) 2323 Life Insurance Policies

2324 Lump Sums

2325

Patient Fund Account (NH)

2326 Prepayments and Deposits (NH)

2327 Property Essential to Self-Support

2328

Property Rights

2329 Real Property, Non-Homeplace

2330 Relocation Assistance

2331

Replacement Funds

2332 Retirement Funds

2333 Safe Deposit Box

2334 Savings and Checking Accounts

2335 Stocks and Mutual Fund Shares

2336 Trust Property - Medicaid Qualifying

2337

Trust Property - OBRA ‘93

2338 Trust Property

2339

Annuities

2340 Uniform Gifts to Minors

2341 Victim’s Compensation

2342

Transfer of Assets for ABD Medicaid

2343 German Reparation Payments

2344

Qualified Tuition Savings Programs (529 Plans)
















































2300 (cont.) 2345 Undue Hardship

2346 Special Needs Trust

2347 Loans

2348 Long Term Care Insurance Partnership

2349 Personal Care Contracts

2398 Estate Recovery for ABD Medicaid

2399 Treatment of Resources by Resource Type Chart

2400

INCOME

2401 Medicaid Income Overview

2403 Ownership of Income

2405

Treatment of Income

2407 Qualified Income Trust

2410 Rental Income

2415 Self-Employment

2418

VA INCOME

2420 Military Pay

2430

Living Arrangement and In-Kind Support and Maintenance for ABD Medicaid

2499 Treatment of Income in Medicaid Chart

2500

ABD FINANCIAL RESPONSIBILITY AND BUDGETING

2500

ABD Financial Responsibility and Budgeting Overview

2501 Marital Relationship

2502 Deeming

2503 Couples
















































2500 (cont.) 2504 Determining Countable Income

2505 Income Deductions

2506 Medicaid Individual Budgeting

2507 Spouse to Spouse Deeming

2508 Parent to Child Deeming

2509 Couple Budgeting

2510 Medicaid Cap Budgeting

2550

PATIENT LIABILITY/COST SHARE

2551 Patient Liability/Cost Share Overview

2552 Patient Liability/Cost Share Deductions

2553 Protection of Income

2554 Diversion of Income

2555

Incurred Medical Expenses

2557

Averaging Income and Incurred Medical Expenses

2558 Significant Change in Income or IME

2559

Patient Liability/Cost Share Budgeting

2575

NURSING HOME VENDOR PAYMENT

2576 Vendor Payment Authorization

2577 Limited Stays

2578

SSI Recipients

2579 SSI 1619 Individuals

2580

SSI Recipients Temporarily in a Nursing Home











































2575 (cont.) 2581 Swing Beds

2582 Temporary Absence from Nursing Home

2600 FAMILY MEDICAID ASSISTANCE UNITS AND

BUDGET GROUPS

2610 MAGI Budget Groups/Assistance Units

2620

Non-MAGI Budget Groups/Assistance Units

2640 Paternity

2650

FAMILY MEDICAID BUDGETING

2650 Family Medicaid Budgeting Overview

2653 Prospective Budgeting (Family Medicaid)

2655

Family Medicaid Deductions

2657 Penalized Individuals

2659 Contract Employees

2661 Responsibility Budgeting

2663

Non-MAGI Budgeting

2667 TMA Budgeting

2669 MAGI Budgeting

2671 Family Medicaid Medically Needy Budgeting


































2700

CASE MANAGEMENT

2700 Case Management Overview

2701 Notification

2706 Medicaid Renewals

2708 ABD Medicaid Changes

2712 Family Medicaid Changes Overview

2713

Family Medicaid Changes in Residence

2714

Family Medicaid Changes in AU Composition

2715 Family Medicaid Changes in Income

2716 Family Medicaid Miscellaneous Changes

2718 PeachCare for Kids® Rebounds

2720

Continuous Coverage for Pregnant Women

2750

DCH Reports - Ex Parte Lists

2751 SSA Medicare Savings Programs Applications

2752 DCH Reports - Presumptive Lists

2756 Medicare Buy-in

2760 Case Record Maintenance

2800

ASSISTANCE TO CHILDREN IN PLACEMENT

2801

Assistance to Children in Placement Overview

2805 Funding Sources

2810

Foster Care Medicaid Application Processing

2812

Department of Juvenile Justice Medicaid Application Processing













































2800 (cont.)

2815

IV-E Foster Care Medicaid

2817 IV-E Adoption Assistance Medicaid

2818 Chafee Independence Program Medicaid

2819 Former Foster Care Medicaid

2820

Legal Status

2825 AFDC Relatedness

2826 AFDC Deprivation - Unemployed Parent

2830 AFDC Deductions

2835 AFDC Relatedness Budgeting

2840 IV-E Budgeting

2845

SSI Eligible Child

2848 Relative Care Placement

2850 Special Considerations

2851 Child Support Referrals (IV-E)

2852

Medicaid Application Processing for Out-of-State Children Placed in Georgia

2853 Foster Care CMO Procedures

2860 IV-E Reimbursability

2870 Redeterminations for Children in Placement

2880 Ineligibility for IV-E

2883 Standard Filing Unit

2885

Transition from Foster Care to Adoption Assistance

2890 Foster Care Medicaid Age 18 to 21


















































2900

REFERRALS

2900

Referrals Overview

2901 Aging, Division of

2903 Brain and Spinal Injury Trust Fund

2905 Cancer State Aid Program

2906 Community Based Alternatives for Youth (CBAY)

2907 Champions for Children Program

2908 Children’s Medical Services

2910 Child Support Services

2920 Domestic Violence

2925 Food Stamps

2926 GeorgiaCares

2928 Georgia Hearing Aid Distribution Program

2930 Health Check

2931

Medicare Part D and Low Income Subsidy

2933 Georgia Pediatric Program

2935 Non-Emergency Medical Transportation

2936 Exceptional Transportation Services

2937 Ombudsman

2938 Georgia Family Healthline

2939

Money Follows the Person

2940 Prescription Prior Approval












































2900 (cont.) 2942 Public Health

2945

Refugee Assistance Program

2947 Healthcare Facility Regulation (DCH)

2950

Rehabilitation Services (DOL)

2955

Service Options Using Resources in a Community Setting (SOURCE)

2960 Temporary Assistance for Needy Families (TANF)

2980 Voter Registration

2985 Women, Infants and Children (WIC)

Appendix A1

ABD Financial Limits

Appendix A2

Family Medicaid Financial Limits

Appendix B

Hearings

Appendix C

Medicaid Issuance

Appendix E

Glossary

Appendix F

Forms

Appendix G

Cover Letters

Appendix H

Administrative Reviews

Appendix L

Long Term Care Project

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