WAG 15-07-01: Backdating Medical Eligibility

PM 15-07-01

Take the following action when eligibility does not exist for the month of disposition, but does exist for from one to 3 months before the month of application:

  1. (FCRC) Process a TA 10 through AIS or IPACS to approve and cancel the pending application.
  2. (System) If entry is via AIS, sends Form 360C telling the client of the approval and denial action taken on the pending application.

    NOTE:If a case is enrolled in spenddown, the Family Community Resource Center must issue the approval notice. 

  3. (FCRC) If entry is made via IPACS, complete Form 552 to approve Medical for the eligible month(s). In Item 77 enter the first day of the earliest month of eligibility, if eligibility existed for more than one month. Complete and send Form 458D as the approval notice for the backdated months.

Medical Backdate Approved Under a Different Category of Assistance

Process a TA 10 through IPACS to approve and cancel for backdate months only:

  • when an application is approved through AIS, and
  • the case is not spenddown, and
  • the case is eligible for medical backdate in a category other than the one under which it is approved to receive ongoing assistance.

With the approval of ongoing assistance, register the category of assistance for the backdate months. Process a TA 10 to approve and cancel for the backdated months.

If the original Medical application was approved through the AIS, the centrally issued approval notice tells the client of the eligible backdate months.

NOTE: If a case is enrolled in spenddown, the Family Community Resource Center must issue the approval notice.

If the original Medical application was approved through IPACS, complete and send HFS 458 regarding eligibility for the backdate period. Do not send the client an approval notice regarding eligibility for the backdate period.