Residential Care and Assisted Living Compendium: 2007. Time Frame for Determining Medicaid Eligibility

11/30/2007

Some states may not determine eligibility for services until financial eligibility has been determined, a process that can take up to 45 days or longer if further documentation of income or assets is needed. An extended time frame for determining Medicaid eligibility can be a major deterrent to participation in the Medicaid program, because providers will generally not want to admit someone if they are unsure about payment. If Medicaid eligibility cannot be determined quickly, beneficiaries in the midst of a transition, such as discharge from a hospital, may be more likely to enter a nursing home.

Some states expedite the determination of Medicaid eligibility or allow case managers or eligibility workers to “presume eligibility” based on preliminary information. However, if the eligibility presumption is later found to be incorrect, states do not receive federal reimbursement for expenditures made while the determination was pending and must pay providers solely with state funds. Nebraska, Ohio, and Washington have provisions for allowing presumptive eligibility, and Michigan allows Area Agencies on Aging (AAAs), which administer HCBS programs, to make presumptive eligibility determinations as well. Georgia and Pennsylvania have developed initiatives to expedite the application process.

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