016.20.99 Ark. Code R. 009
If a medical visit is canceled after a recipient arrives at a medical facility, the county may authorize for the recipient to go to a rescheduled visit.
If a recipient cancels a visit after transportation funds have been issued and uses the money for something else, funds should not be issued to this recipient until after the next medical visit is authorized (i.e., postauthorize and postissue funds for the rescheduled visit). The first issuance which was not utilized for transportation should be treated as an overpayment.
County offices may authorize transportation to recipients who live in adjoining counties if the issuing county is more convenient for the client due to distance.
Additional bank funds may be requested by memorandum to the Administrator, Accounting Section, Division of Administrative Services, P. 0. Box 1437, Slot 3205, Little Rock, AR 72203.
When bank funds are near depletion and there is knowledge that it will take several days to replenish them, existing funds cannot be reserved for individual clients. Funds will be dispersed on a first come, first serve basis.
Public Law 100-203, OBRA of 1987, mandates that the Office of Child Support Enforcement (OCSE) provide services to all Medicaid-only persons/families who have assigned to the State their rights to medical support. Each applicant or recipient must cooperate with OCSE in establishing legal paternity and obtaining medical support for each child who has a parent absent from the home.
OCSE roust provide all appropriate services to Medicaid-only applicants/recipients without the OCSE application or fee. The OCSE agency is required to petition for medical support when health insurance is available to the absent parent at a reasonable cost. OCSE will also collect child support payments from the absent parent unless OCSE is notified by the recipient in writing that this service 1s not needed. Child support payments collected on behalf of Medicaid-only families are received and distributed to the custodial parent through the Central Office Child Support Clearinghouse. However, no recovery cost will be collected.
OCSE referrals will be made at each new certification for:
all Medicaid eligible children under the age of 18 who have one or both parents absent from the home, and
all Medicaid eligible children under the age of 18 who were born out of wedlock, including situations where both parents are living in the home. The father will be referred for the establishment of paternity only.
Act 1091 of 1995 amended by Act 1296 of 1997 requires that both parents sign an affidavit acknowledging paternity or obtain a court order before the father's name will be added to the birth certificate.
Note: If the father's name is included on the birth certificate of a child born 4/10/95 or later, paternity has already been established. As paternity establishment is the only service the Office of Child Support Enforcement can offer to a family when both parents are in the home, there is no need to make a referral in these instances.
EXCEPTION: SOBRA pregnant women will not be required to cooperate with the OCSE on Medicaid certified children, until after their postpartum period has ended. A woman who is eligible for Family Planning Waiver services only is not required to cooperate with OCSE.
A parent is considered to be absent for Medicaid purposes when the absence is due to divorce, separation, incarceration, institutionalization, participation in a Rehabilitation Service Program away from home, or military service, regardless of support, maintenance, physical care, guidance, or frequency of contact.
When a referral for Newborn Coverage (Categories 52 and 63) is received by the county, the worker will determine if there is an absent parent and obtain enough information to complete the DC0-115. Certification of the newborn in the 20-day period allowed for certification will not be delayed due to lack of absent parent information or due to non-cooperation by the newborn's mother.
Both parents of a Medicaid eligible child voluntarily placed in an institution or court ordered to an institution will be referred to the OCSE, whether or not the parent(s) were absent at the time the child was removed from the home.
Absent parents of all foster children will be referred to OCSE by the Division of Children and Family Services Eligibility Specialist.
The guidelines found in FA 2245 through 2249.2 will be used as the guidelines for the Medicaid OCSE referrals, including the "good cause" policy.
The County Office Worker will explain the assignment of Medical Support on page four of the DCO-95 and will explain the OCSE requirements at each new application interview.
The form DCO-115, Absent Parent Information, will be completed for entry to WAPU (Absent Parent Information Screen) for each Medicaid eligible chiId who has an absent parent or when 1 egal paternity must be established. Upon receipt of the referral, OCSE will initiate steps to contact the custodial and noncustodial parents.
A DCO-90, Notice Concerning Good Cause For Refusal to Cooperate, will also be completed at each application interview.
Forms DCO-116, Client Statement Regarding Absent Parent, and DCO-117, Absent Parent Statement, need not be completed for Medicaid-only cases, with the exception of AFDC related Medicaid cases where deprivation is an eligibility requirement.
When Medicaid eligibility has ended, OCSE will notify the custodial parent that support services will continue. The custodial parent must advise OCSE in writing if they do not want these services to continue.
The County Office will be notified via form OCSE-1650 when an individual fails to cooperate with the OCSE in establishing paternity and medical support. Cooperation in establishing child support payments is not a requirement for Medicaid-only cases.
For Medicaid, a child's benefits cannot be denied or terminated due to the refusal of a parent or another legally responsible person to assign rights or cooperate with OCSE in establishing paternity or obtaining medical support.
In family Medicaid categories, the needs of an adult relative who refuses to cooperate with OCSE will continue to be included in the need standard along with the child, but Medicaid for this individual will end after the appropriate notice period has expired. The status of the individual will be "C" with an "M" in both the Budget Indicator and TEMO fields. It is not necessary to obtain a protective payee for the child when the adult relative has refused to cooperate.
* As the needs of an adult relative are never included in the need standard with an eligible child in Aid to the Blind or Disabled Medicaid categories, the failure of an adult relative to cooperate with OCSE will have no effect on the child's Medicaid eligibility.
Each Economic Services Supervisor must establish procedures to insure coordination between Medical Services Programs, Financial Assistance, Food Stamps, Services, and Child Support Enforcement Programs at the County Office level. This will include the exchange of information between County Office personnel on persons receiving benefits under more than one program, and the referral of persons applying for or receiving benefits under one program to any other program for which he may be eligible.
Upon reasonable notice to the county and during county office hours, an applicant ' or recipient has the right to view and/or obtain copies from his case record.
Generally, information concerning an applicant or recipient will not be released to other parties without the individual's written consent. Information may be released without an individual's written consent to:
Confidential information should not be released over the telephone unless county workers are assured that they are talking with individuals who are entitled to the information being requested.
The fact that a person's name is in the authorized representative space on a DC0-95 or DC0-777 does not necessarily mean that he is an authorized representative or that information should be released to him. For example, if an AAA employee helps an elderly person complete an application and the employee puts his name in the authorized representative blank, information should not be released to this person unless requested by the applicant/recipient. If the applicant/ recipient is incapacitated, if the person who completed the application has supplied information for the case record, and if the person has a need to use information in that record to act in some capacity for the benefit of the applicant/recipient, then information can be released.
An authorized representative may change, i.e., the authorized representative who helped to establish original eligibility may not necessarily be the same person who will help reestablish eligibility at reevaluation. For example, if a NF administrator completes the DCO-777 at reevaluation and the original representative was the recipient's daughter, the recipient and/or daughter should " be contacted to determine if the daughter will continue to act as representative to reestablish eligibility.
Medical records and the DCO-109 are a part of an applicant's or recipient's case record and, as such, will be considered according to MS 1330. At county discretion, medical records may be destroyed after receipt of the DCO-109 from MRT. However, the DCO-109 must remain in the case record as proof of the disability determination made by MRT.
If a provider furnishes an individual's full name (including middle initial), date of birth, Social Security Number, and date of service, the County Office may release limited information. Information which may be released is limited to Medicaid ID #, beginning date of eligibility, whether or not a recipient was eligible on a specific date, services for which an individual is eligible, and TPL information (including policy numbers and type of coverage, if known). It will be an administrative decision whether or not time and staff are available to provide the information.
016.20.99 Ark. Code R. 009