DADS published an information letter to provide assistance to service coordinators, case managers, and program providers on how to identify an individual’s Medicaid type program (TP) and to identify if a certified Medicaid TP is categorized as Medical Assistance Only (MAO).
Individuals certified for MAO Medicaid by the Health and Human Services Commission (HHSC) receiving Community First Choice (CFC) services through a 1915(c) Waiver Program must meet eligibility requirements stated in 42 Code of Federal Regulations (CFR) §441.510(d) and explained in IL 2015-28, IL 2015-29, IL 2015-30, and IL 2015-31. The 42 CFR §441.510(d) states an individual certified for MAO must receive at least one waiver service per month.Please note the eligibility requirement of receiving at least one waiver service monthly is in addition to CFC services received.
Home and Community-based Services (HCS) and Texas Home Living (TxHmL) service coordinators and program providers can access Client Assignment and REgistration (CARE) system to identify an individual’s Medicaid TP. Search for the individual’s Medicaid eligibility information by CARE ID or Medicaid Number in the “C63: MEDICAID ELIGIBILITY SEARCH” screen. Once the selected individual’s Medicaid eligibility information is displayed, refer to the column labeled “TYPE PROG” to identify the individual’s Medicaid TP.
Community Living Assistance and Support Services (CLASS) and Deaf Blind with Multiple Disabilities (DBMD) program providers can locate individual’s Medicaid TP information in the “Eligibility” section in Medicaid Eligibility Service Authorization Verification (MESAV) system. The column labeled “Program Type” within this section identifies the individual’s Medicaid TP. After identifying an individual’s Medicaid TP, a service coordinator, case manager, or program provider is encouraged to use the attached MAO Waiver Chart to identify if the Medicaid TP is categorized as MAO. An individual’s whose Medicaid TP is categorized as MAO must meet the CFC requirement stated in 42 CFR §441.510(d).
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