PM 06-06-02-a

For persons identified on SDX as Section 1619 eligible and who meet the nonfinancial eligibility requirements:

  1. (System) Enters code 380 QSII (Qualified Severely Impaired Individual) in Item 80.
  2. (System) Generates a TA 32/TAR 57 to delete the spenddown amount.
  3. (System) Generates a turnaround Form 552 with the Item 93 message:

    ITEM 80 380 QSII ADDED 

  4. (System) Sends Medicaid Eligibility for Persons in Section 1619 Status (Form 2434G) to tell the person they are eligible for medical coverage without a spenddown.
  5. (System) Authorizes a MediPlan Card for each month the person is in Section 1619 status.

For persons identified on SDX as no longer Section 1619 eligible:

  1. (System) Deletes code 380 QSII in Item 80 using TA 32/TAR 61.
  2. (System) Generates a turnaround Form 552 with the Item 93 message:

    ITEM 80 380 QSII DELETED 

  3. Sends Notice of Loss of Section 1619 Status (Form 2434H) to the client.
  4. Identifies the case on the batch exception Report #82-30074-01, indicating:

    ITEM 80 380 QSII DELETED, DETERMINE ELIGIBILITY/SPENDDOWN STATUS 

  5. (FCRC) See WAG 18-05-04 to approve medical when a client loses Section 1619 status.