State Residential Care and Assisted Living Policy: 2004. Time Frame for Determining Medicaid Eligibility

03/31/2005

Some states may not determine eligibility for services until financial eligibility has been determined, a process that can take up to 45 days. 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, especially those being discharged from a hospital, may be more likely to enter a nursing home. To address this problem, 11 states report having a process for expediting eligibility determination: Colorado, Connecticut, Florida, Georgia, Idaho, Maryland, New Mexico, North Carolina, Oregon, Washington, and Wisconsin.

Some states expedite the determination of Medicaid eligible or allow case managers or eligibility workers to "presume eligibility" based on preliminary information. However, if the eligibility is later found 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 its Area Agencies on Aging, which administer HCBS programs, to have such provisions as well. Georgia and Pennsylvania have developed initiatives to expedite the application process.

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