MR #14.14: Providing Information for Medical Cases

Healthcare and Family ServicesDepartment of Human Services

6/09/14

Summary

  • Adds the requirement to allow 10 days for clients to provide required information
  • Adds the requirement to send a copy of requests for information and the approval or denial notice for LTC clients to the facility or Department on Aging Community Care Program
  • Adds policy on reopening medical applications in a section of the manual that was missed in MR #14.09 Reopening Denied Medical Applications
  • Adds Policy Memo AABD Medical Central Rede Clarification to the manual

This release adds the requirement to allow the client 10 days to provide required information necessary to determine eligibility. Clients may be given an extension for obtaining verification from a third party or when an unusual circumstance makes it difficult for the client to cooperate within the 10 days. If a client fails to provide required information necessary to determine eligibility for the household, cancel the case. If the requested proof only affects the eligibility of one of the individuals, delete that individual. Do not delete a newborn under age 1 or a pregnant woman covered under Moms & Babies (per PM 06-09-01). 

If the client fails to verify income deductions or medical expenses, do not allow the expenses or deductions.

For LTC (nursing home, supportive living program, Department on Aging Community Care Program) clients, send a copy of Form 267LTC, Form 1721 or any other requests for additional information and the approval/denial notice, Form 458SP or Form 458 LTC to the client, any authorized representative, and to the LTC facility or the Community Care Program. 

Adds information on when AABD cases are centrally redetermined and obsoletes Policy Memo AABD Medical Central Rede Clarification.

MANUAL REVISIONS

[signed copy on file]

Michelle R.B. Saddler

Secretary, Illinois Department of Human Services

Julie Hamos

Director, Illinois Department of HealthCare and Family Services

Forms referenced:

HFS 458SP

HFS 1721

HFS 458LTC