Summary:

  • Clarifies the criteria for central completion of REDEs for AABD Medical cases.
  1. Community cases
  2. LTC and SLF cases

This memorandum was prepared by the Illinois Department of Public Aid. DPA administers the Medicaid and KidCare programs. These programs provide medical benefits to families with children and other persons. This information is to be used by staff of the Illinois Department of Human Services when determining eligibility and authorizing medical benefits for these persons on behalf of DPA.

This memorandum clarifies the criteria used for completing central REDEs for some AABD Medical cases (Category 91, 92, 93). A central REDE is completed and reported in Item 30 on Form 552 when the following codes are present:

Community cases

  • Item 20 contains a code 16, 17, 18, or 19; and
  • Item 32 date is prior to or equal to the effective date; and
  • Item 80 does not contain a code 390 or 391; and
  • Item 90 contains code 691 without a source code; and
  • REMARKS field does not contain an SSI exclusion code.

LTC and SLF cases

  • Item 20 contains a code 11, 12, or 15; and
  • Item 32 date is prior to or equal to the effective date; and
  • Item 80 does not contain a code 391; and
  • Item 90 contains code 691 and no other income code.

A central REDE using the above criteria is not completed for Health Benefits for Workers with Disabilities (HBWD) and Health Benefits for Persons with Breast or Cervical Cancer (BCC) cases. REDEs for these cases are completed by the central units in DPA.

[signed copy on file]

LINDA RENEÉ BAKER
Secretary, Illinois Department of Human Services

A. GEORGE HOVANEC
Acting Director, Illinois Department of Public Aid

Forms referenced:
Form 552