Medical Assistance Eligibility Handbook Policy Clarifications

PC Number

Description

Chapter/Section or Appendix

PC Date

PMA18163323

County of Residence for Individuals Placed in an Inpatient Drug and Alcohol (D&A) Facility

323.4

August 29, 2016

PMN18079489

Overlapping 902Z and 903Q TPLs on Long term Care (LTC) records of recipients

489.1

June 27, 2016

PMA18053312

No MG 91 and MG 90 Eligibility for Individuals Entitled to Medicare

312.1,   319.1

June 7, 2016

PMA17994312

MG19 Eligibility Criteria

312.1

May 2, 2016

PMC17977317

Evaluating Eligibility for BCCPT (PH 20)

317.1,  305.1

April 21, 2016

PMA17942312

Income Limits for the MG 90 N Category

312.1

March 29, 2016

PMA17941304

Application Date for Family Planning Services (FPS)

304.14

March 29, 2016

PMA17849312

Payments Received Under Home and Community Based Services (HCBS) Wavier Programs and Modified Adjusted Gross Income (MAGI) Medical Assistance (MA) Determinations

312

January 29, 2016

PMA17845318

Federal Poverty Income Guidelines

312 App A, B, C, D

316 App A

319 App A, B, C

January 29, 2016

PMA17839319

Decreased Mileage Rate for Unearned Income Deduction

319.71

January 27, 2016

PMA17827372

Increase in Gross Social Security Income and Medicare Part B Premium Effective January 2016

372

January 14, 2016

PMA17785350

2016 Medicare Part B Premium

350

November 24, 2015

PMA17778309

Medical Assistance (MA) Recipients and Free or Reduced-Price School Meals

309.94

November 23, 2015

PMA17770319

Increased Mileage Rate for Unearned Income Deduction

319.71

November 17, 2015

PMA17754304

Federally-Facilitated Marketplace (FFM) Open Enrollment Period for 2016

304.1

October 29, 2015

PMA17691377

Advance Notice for Health Premium Payment (HIPP) Non-Cooperation

338.2

September 17, 2015

PMA17609304

Processing time Frame and Reconsideration period for Federally-Facilitated marketplace (FFM) Applications

304.14,   304.5

Revised  September 16, 2015

Original date July 2015

PO17680910

MA Overpayment and Family Planning Services

312.1

September 4, 2015

PMA17609304

Processing Time Frame and Reconsideration Period for Federally Facilitated Marketplace (FFM) Applications

304.14,  304.5

July 2015

PMS17545391

Personal Care Home (PCH) Supplement and Appropriate Client Notification      

391.43

May 7, 2015

PMA17542312

Care and Control of Children for Modified Adjusted Gross Income (MAGI) Medical Assistance (MA)

312.2

May 7, 2015

PMA17471338

Hospice Forms Sent to CAOs

338.65,   438.7

March 16, 2015

PMA17450312

Medical Assistance for Former Foster Care Recipients

312.81

February 23, 2015

PMA17447380

Issuing Replacement ACCESS Card for Medical Assistance (MA) Recipients

380.5

February 20, 2015

PMA17446312

Annualized Income for MA Budgets that use Modified Adjusted Gross Income (MAGI) to Determine Eligibility

312.8

February 20, 2015

PMA17427388

Increase in Resources Limits for the Medicare Savings Program

319 Appendix A,   B,  C,  

 388 Appendix B

January 29, 2015

PMA17420376

Medical Assistance (MA) Renewals due in January 2015 and February 2015

Not linked

January 23, 2015

PMA17419304

MA and Drug & Alcohol Facility Codes

Not linked

January 23, 2015

PMA17417318

2015 Federal Poverty Income Guidelines

Not linked

January 22, 2015

PMA17415304

Disability Verification with Healthy PA

304.53,  378.31

January 22, 2015

PMA17400304

Application for Medical Assistance and Resources Verification

304.53,    378.31

January 12, 2015

PMA17393312

Income Excluded for Modified Adjusted Gross Income (MAGI) Medical Assistance (MA) determinations.

312.5

January 6, 2015

PMA17374304

Health Screening and MA Applications Pended until December 1, 2014

Not linked

December 8, 2014

PMA17378376

Semi-Annual Reporting (SAR) Processing and Medical Assistance

376.4

December 4, 2014

PMA17361304

Verification of Income

304.52    378.31

October 30, 2014

PMA17185304

Hospital based Presumptive Eligibility (PE) Determined By PE Qualified Hospital Providers and COMPASS Applications

304.1

October 9, 2014

PMA17324378

Changes in SSA Field Office Verification Services

378.1

October 2, 2014

PMS17301391

Personal Care Home (PCH) Supplement for Recipients of the Person/Family Directed Support (P/FDS) Waiver or Adult Autism Waiver (AAW)

391.1

September 15, 2014

PMA17287322

Authorizing Medical Assistance (MA) eligibility for Temporary Residents

322.1

August 26, 2014

PMA17285350

Adoption Subsidies and Modified Adjusted Gross Income (MAGI) Medical Assistance Determinations

350.6

August 22, 2014

PMA17185304

Hospital Based Presumptive Eligibility (PE) Determined By PE Qualified

Hospital Providers and COMPASS Applications

304.1

June 12, 2014

PMN17136404

Applications for MA Recipients entering a LTC facility

368.5

May 12, 2014

PMA17131378

Additional Verification of UC/EUC Benefit Status

378.61

May 7, 2014

PMA17095378

Extended Unemployment Compensation (EUC) and data Exchange 2

378.1

April 16, 2014

PMA17075378

Verification Requirements and Options

378.1

April 1, 2014

PO17055730

Authorizing Medical Assistance (MA) for Refugees

730.5, 305.1

March 18, 2014

PMA17052392

Incarceration Facility Code 72

Not linked

March 13, 2014

PMA16990378

Changes in SSA Field Office Verification Services

378.1

Revised February 20, 2014

Original January 27, 2014

PMA17019340

Use of Health Savings Account as a Resource

340.1

February 18, 2014

PMA17018376

Reconsideration Period at Application and Renewal for Medical Assistance (MA)

376.1   304.3

February 18, 2014

PMA17017378

Self-Attestation for Verification of Pregnancy for Medical Assistance (MA)

378.3    

February 18, 2014

PMH17009319

Updated PA 600M Insert Using 2014 Federal Poverty Income Guidelines (FPIGs)

304 Appendix E

February 10, 2014

PMT16988339

Transitional Medical Assistance (TMA) after the closure of Transitional Cash Assistance (TCA)

339.1

January 27, 2014

PMC16979317

Breast and Cervical Cancer Prevention and Treatment program (BCCPT) Renewal Address                     

317 Appendix C & Appendix D

 

January 15, 2014

PMW16974316

MAWD Premium Processing

Not linked

January 14, 2014

PMW16958316

November 2013 MAWD Premium Processing

Not linked

December 19, 2013

PMA16943338

Newborns Born to a SelectPlan Mother

311.2,   338.4

 

 

December 3, 2013

PMA16941310

Counting SSI and TANF recipient income in MAGI budgets

310

 

 

November 27, 2013

 PO16867950

Social Security Number Delays Due to the Shutdown

304.4

October 2013

PMS16771350

Federal Tax Refund Exclusion Update

350.61,  340.82

July 23, 2013

PMN16745350

MA copay rebate checks

319.63,  350.61,

 357.1

July  2013

PMW16716316

Home and Community Based Services (HCBS) in a Medical Assistance for Workers with Disabilities (MAWD) Category

316

June 2013

PMA16708340

Resource Determination for Individuals without Bank Accounts

340.3,    378.1

June 2013

PMA16615350

Unemployment Compensation and Sequestration

350.3

Revised May 20, 2013

April 2013

PMN16596468

LTC Facility Private Pay Rate and Coverage of Retroactive Medical Bills

360.6,      361.5

April 2013

PMG16543305

Medical Assistance and SNAP benefits for Individuals Subject to the Five Year Bar

305.42

Revised 04/08/13

February 2013

PMA16506318

2013 Federal Poverty Income Guidelines

Not linked

January 2013

PMA16491309

Children's Health Insurance Program (CHIP) Contractor Service Area Changes

309.6

January 2013

PMA16470322

Managed Care Coverage for Non-Citizens

322

December 24, 2012

PMA16412376

Semi-Annual Reporting and Renewals for October 2012

376

November 7, 2012

PMG16330338

Inability to Pay Copayments

338.52

September 6,2012

PMA16208338

Lodging at Ronald McDonald House

338.62

Revised- August 10, 2012

PMA16196910

MA Overpayment Process Guidance

Not linked

May 15, 2012

PMA15361930

Law Enforcement Requests for Information

Not linked

Revised May 8, 2011

July 7, 2010
(original date)

PMA16170378

PARIS Federal Match Issues

378.1

May 1, 2012

PMA16167376

Budget Alignment issues

376

April 24, 2012

PMA16142338

Changes to Medical Assistance Copayments

338 Appendix D

April 4, 2012

PMG16124304

Retroactive GA-related MA and Bench Warrants

304 Appendix C

March 19, 2012

PMH16121319

Extension of Qualifying Individuals (QI-1s) Program

319.124, 305.21

March 19, 2012

PMN16058389

Home and Community Based Services (HCBS) and Supplemental Nutrition Assistance Program (SNAP) Budget Alignment

389.1

January 23, 2012

PMA15966304

Agents of Medical Assistance (MA) Providers

  Not linked

October 17, 2011

PMG15907305

General Assistance for Individuals Subject to the Five Year Bar

305 Appendix C
322.3

August 25, 2011

PMN15841389

Procedures for Certain Waiver Programs under the Office of Long Term Living

Not linked

June 27, 2011

PMW15803316

Employment Verification for MAWD Eligibility Determinations

316.22

June 6,2011

 

PMN15762403

Managed Care Organization (MCO) Disenrollment for an Active Medical Assistance (MA) Recipient entering a Long Term Care (LTC) Facility

338.57, 368.5

May 25, 2011

PMA15796350

Treatment of Income from Participating in Clinical Trials for Rare Diseases and Conditions

340.83, 350.62, 350.63

May 24, 2011

PMT15633309

Change to CHIP Contractors

309.6

January 31, 2011

PMN15574389

Money Follows the Person (MFP) and the Living Independence for the Elderly (LIFE) Program

489.1

December 8, 2010

PMN15565389

Procedures for HCBS Waiver Programs under the Office of Long Term Living

389.1

December 1, 2010

PMS15457305

CHIP and Children with Special Needs Category-Questions and Answers

305

September 9, 2010

PMA15411350

Update on UC, EUC and EB in Pennsylvania

350.3, 357.1

August 2, 2010

PMH15375319

MIPPA Q & A

Not linked

July 12, 2010

PMA15343309

Children’s Health Insurance Program Reauthorization (CHIPRA) and Newborn Eligibility

309.32, 338.41

July 8, 2010

PMT15364309

Have there been changes to the CHIP and adultBasic contractor contacts?

309.6

July 7, 2010

PMH15363319

MIPPA Files and Residence

Not linked

July 1, 2010

PMP15294311

Eligibility and Renewal Date for a SelectPlan Budget at the End of Medical Assistance (MA) Postpartum Coverage

311.3

May 25, 2010

PMN15281477

0192 Waiver Notices

389.2

May 13, 2010

PMH15280319

Appeals of MIPPA Case Rejection

Not linked

May 12, 2010

PMA15234309

CHIP and AdultBasic Contractor Changes

309.6

August 13, 2010

PMG15213305

Minimum Wage and Small Employers

305.5

April 1, 2010

PMA15169338

Automatic Newborn Eligibility and OMAP Notification

338.41

March 4, 2010

PMA15167338

Adding Newborn to an Existing MA Budget

338.41

March 4, 2010

PMA15089338

Health Care Handshake Referrals

Not linked

January 13, 2010

PMA15018319

MAWD vs. Healthy Horizons

Not linked

November 13, 2009

PMA15012338

Medical Assistance (MA) and SelectPlan Eligibility Review At Conclusion of Post Partum Coverage

338.42

November 4, 2009

PMA15013850

MCO Coverage for an Adopted Child

338-E

November 3, 2009

PMA15011309

CHIP and aB Changes

309.6

November 3, 2009

PMA14988350

Reimbursement of Out-of-Pocket Subsidized Child Care Expenses

350.6

October 19, 2009

PMA14965309

CHIP Contractor Coverage Changes

309.6

September 30, 2009

PMA14882338

HealthCare Handshake Issues

Not linked

July 23, 2009

PMA14869360

Medical Coverage Codes in CAMEDX

360.6, 361.5

July 22, 2009

PMA14846350

Treatment of Summer Youth Program Wages

350.1

July 7, 2009

PMH14744350

PH-95 Income Eligibility

319.62, 319.621, 350.5

April 30, 2009

PMN14671404

Home and Community Based Services Application Requirements for Active Medical Assistance (MA) Recipients

389.1

March 19, 2009

PMA14542350

Simmons v. Snider Settlement Reimbursement Check

Link pending

December 12, 2008

PMS14496340

Medicare Eligibility

388.1, 340.13

November 13, 2008

PMA14456350

Individuals Receiving Social Security from Multiple Claims

350.3

October 14, 2008

PMA14455350

Individuals Receiving Veteran’s Benefits from Multiple Claims

350.3

October 14, 2008

PMA14332369

MNO Period after Leaving a Facility

369.41, 369.5

September 24, 2008

PMA14385340

Bank Account Information Request

340.31, 378-A

August 27, 2008

PMA14537304

Use of PA-4 (Authorization for Release of Information) and Medical Assistance Eligibility

376.23

Revised 08/11/08

PMN14337389

Revised Tracking Form for Married HCBS Applicants

389.4

July 24, 2008

PO14292980

Voter Registration Code Issues

304.42

July 16, 2008

PMP14154311

SelectPlan for Women and TD 55 NCE Periods

305.5

July 7, 2008

PMS13182340

Workers Compensation Medicare Set - Aside Arrangement (WCMSA)

340.83

June 27, 2007

PMS13662305

TAW and TJW Categories

305.22, 305.23, 305.24

May 30, 2007

PMW13657316

Title V Earnings

316.22, 316.44

June 14, 2007

PMS13557388

Enrollment in Buy-In and Refusal of Medicare

388

April 5, 2007

PMS13372389

PDA Waiver Eligibility Notices

389.1

October 10, 2006

PMW12967316

Income of MAWD Individual/Medicaid for Other Family Members

316.23

August 18, 2006

PMA13085338

Pregnant Woman Refuses to Provide TPL Information

338.42

July 27, 2006

PMS12993340

Dual Eligible and Continuation of Coverage Beyond Coverage Limit

340.13

May 25, 2006

PMA13014338

Special Pharmaceutical Benefits Program

334.64

April 26, 2006

PMS9240850

Program Status Code 34 and SSI Child

Not linked

October 2, 2000

Updated March 13, 2014   Replacing  February 14, 2012,