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COMMONWEALTH OF KENTUCKY by 9393ely

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									                             COMMONWEALTH OF KENTUCKY
                           Cabinet for Health and Family Services
                         Department for Community Based Services
                                    Frankfort, Kentucky


                                                            Operation Manual
                                                            Transmittal Letter No. 344
                                                            November 1, 2009

To:            All Field Staff

Subject:       Incorporation of Volume I Material into Volumes IV and IVA

Volumes IV and IVA are revised to incorporate policy and procedures removed from
Volume I, and to update policy and procedures with current information.

                                        Volume IV

The Table of Contents is revised to add the following manual sections:

MS    1100,   Disclosure of Information;
MS    1150,   Vendor Billing/Service Information;
MS    1205,   Taking the Application;
MS    1213,   Who Signs the Application;
MS    1250,   Case Record;
MS    1252,   Case Number Assignment;
MS    1254,   Assignment of Caseload Codes;
MS    1256,   Determining Caseload Code and County of Residence;
MS    1342,   Caseload Responsibility;
MS    1460,   Timely Notice of Decrease, Discontinuance;
MS    1530,   KYHealth Card;
MS    1540,   Nonreceipt of KYHealth Cards;
MS    1600,   Managed Care;
MS    1602,   Definitions;
MS    1604,   KYHealth Card and Managed Care Card;
MS    1606,   Worker Responsibilities/Beneficiary Groups;
MS    1608,   Guaranteed Coverage;
MS    1700,   Out-of-State Medicaid Inquiries;
MS    1710,   Out-of-State Request for Termination of Medicaid;
MS    1720,   SSI Recipients Moving to Kentucky;
MS    2012,   SSN Applications;
MS    2014,   Failure to Comply;
MS    2016,   Enumeration Good Cause Criteria;
MS    2018,   Use of the SSN;
MS    2035,   Citizenship and Identity Requirements for MA Programs;
MS    2036,   MA Case Processing for Citizenship Verification;
MS    2037,   Criteria for Qualified Aliens;
MS    2038,   Time-Limited MA Eligibility;
MA    2039,   Extension of Time-Limited MA;
MS    2170,   KenPAC Introduction;
MS    2172,   KenPAC Provider Services;
MS   2174,   KenPAC Providers;
MS   2176,   KenPAC Provider Assignment
MS   2178,   KenPAC Provider Changes;
MS   2180,   KenPAC Exempt Recipients;
MS   2182,   KenPAC Special Authorization;
MS   2186,   KenPAC Grievance Procedure;
MS   2188,   KenPAC Hearings; and
MS   2190,   Transfer of KenPAC Case Records between Counties.

MS 1100, Disclosure of Medicaid Information, is created to incorporate Medicaid
procedures from Vol I, MS 0126.

MS 1150, Vendor Billing/Service Information, is created to incorporate procedures
from Vol I, MS 0459. The material is revised to incorporate current referral
information.

MS 1200, Right to Apply, is re-named and revised to incorporate procedures from
Vol I, MS 0093 and MS 0094. The material is revised to delete references to the PA-
62 system.

MS 1205, Taking the Application, is created to incorporate procedure from Vol I, MS
0095.

MS 1213, Who Signs the Application, is created to incorporate procedures from Vol I,
MS 0096. The material is revised to delete procedures for obsolete form MA-7.

MS 1250, Case Record Content, is created to incorporate procedures from Vol I, MS
0159. The material is revised for clarity.

MS 1252, Case Number Assignment, is created to incorporate procedures from Vol.
I, MS 0153. The material is revised to delete references to the PA-62 system.

MS 1254, Assignment of Caseload Codes, is created to incorporate procedures from
Vol I, MS 0174. The material is revised to reflect current caseload/security request
procedures.

MS 1256, Determining Caseload Code and County of Residence, is created to
incorporate procedures from Vol I. MS 0175. The material is revised to remove
references to the PA-62 system and the Human Services Tansportation Delivery
system.

MS 1342, Caseload Responsibility, is created to incorporate procedures from Vol I,
MS 0155. The material is revised for clarity.

MS 1460, Timely Notice of Decrease, Discontinuance, is created to incorporate
procedures from Vol I, MS 0553. The material is revised to remove references to the
PA-62 system and for clarity.

MS 1470, Exceptions to Timely Notice Requirements, is revised to incorporate
procedures from Vol I, MS 0559.

MS 1530, KYHealth Card, is created to incorporate procedures from Vol I, MS 0450.
The material is revised for clarity.
MS 1540, Nonreceipt of KYHealth Cards, is created to incorporate procedures from
Vol I, MS 0456.

MS 1600, Managed Care Enrollment, is created to incorporate procedures from Vol I,
MS 0350.

MS 1602, Definitions, is created to incorporate procedures from Vol I, MS 0351. The
material is revised to reflect the current name for the Centers for Medicare and
Medicaid Services (CMS).

MS 1604, KYHealth Card and Managed Care Card, is created to incorporate
procedures from Vol I, MS 0352.

MS 1606, Worker Responsibilities/Beneficiary Groups is created to incorporate
procedures from Vol I, MS 0353.

MS 1608, Guaranteed Coverage, is created to incorporate procedures from Vol I,
MS 0355.

MS 1700, Out-of-State Medicaid Inquiries, is created to incorporate procedures from
Vol I, MS 0462. The material is revised for conciseness.

MS 1710, Out-of-State Request for Termination of Medicaid, is created to incorporate
procedures from Vol I, MS 0457. The material is revised to reflect current telephone
contact referral information.

MS 1720, SSI Recipients Moving to Kentucky, is created to incorporate procedures
from Vol I, MS 0458. The material is revised for clarity and to change the acronym
OSB to MSBB.

MS 2010, Enumeration, is revised to incorporate procedures from Vol I, MS 0650.
The material is revised to delete references to obsolete Social Security
Administration (SSA) forms and procedures and the PA-62 system, and to add the
SSA website address.

MS 2012, SSN Applications, is created to incorporate procedures from Vol I, MS
0656. The material is revised to add the SSA website address, to delete references
to obsolete SSA forms and procedures, to replace E-7 references with KVETS
procedures, and to reflect that SSA now requires face-to-face interviews for first
time SSN applications for individuals age 12 or older.

MS 2014, Failure to Comply, is created to incorporate procedures from Vol I, MS
0653.

MS 2016, Enumeration Good Cause Criteria, is created to incorporate procedures
from Vol I, MS 0659. The material is revised for clarity.

MS 2018, Use of the SSN, is created to incorporate procedures from Vol. I, MS 0662.

MS 2035, Citizenship and Identity Requirements for MA Programs, is created to
incorporate procedures from Vol I, MS 0625.

MS 2036, MA Case Processing for Citizenship Verification, is created to incorporate
procedures from Vol. I, MS 0626.
MS 2037, Criteria for Qualified Aliens, is created to incorporate procedures from Vol
I, MS 2000. The material is revised to incorporate the Federal policy clearance that
Afghan aliens who are exempt from the 5 year waiting period are subject to an 8
month waiting period.

MS 2038, Time-Limited MA Eligibility, is created to incorporate procedures from Vol.
I, MS 2075. The material is revised to clarify that children born to mothers receiving
two-month time limited coverage for the birth month are deemed eligible new borns,
and that time-limited recipients are to be placed in separate cases from ongoing
eligible household members.

MS 2039, Extension of Time-Limited MA, is created to incorporate procedures from
Vol I, MS 2085.

MS 2170, KenPAC Introduction, is created to incorporate procedures from Vol I, MS
0400. The material is revised to reflect current telephone contact information.

MS 2172, KenPAC Provider Services, is created to incorporate procedures from Vol.
I, MS 0406.

MS 2174, KenPAC Providers, is created to incorporate procedures from Vol I, MS
0408.

MS 2176, KenPAC Provider Assignment, is created to incorporate procedures from
Vol. I, MS 0410. The material is revised to incorporate current KenPAC procedures as
outlined in OM Policy Update No. 03-23 which is now obsolete.

MS 2178, KenPAC Provider Changes, is created to incorporate procedures from Vol.I,
MS 0412. The material is revised to incorporate current KenPAC procedures as
outlined in OM Policy Update No. 03-23 which is now obsolete.

MS 2180, KenPAC Exempt Recipients, is created to incorporate procedures from Vol.
I, MS 0403. The material is revised to remove the reference to counties listed as
non-KenPAC. All counties are now KenPAC.

MS 2182, KenPAC Special Authorization, is created to incorporate procedures from
Vol I, MS 0414. The material is revised to reflect current telephone contact
information and for clarity.

MS 2184, KenPAC Provider Special Assignments, is created to incorporate
procedures from Vol I, MS 0416. The material is revised to incorporate current
KenPAC procedures as outlined in OM Policy Update No. 03-23 which is now
obsolete.

MS 2186, KenPAC Grievance Procedure, is created to incorporate procedures from
Vol I, MS 0421. The material is revised to reflect current telephone, mailing address,
and fax information.

MS 2188, KenPAC Hearings, is created to incorporate procedures from Vol I, MS
0422. The material is revised to correct punctuation.

MS 2190, transfer of KenPAC Case Records between Counties, is created to
incorporate procedures from Vol I, MS 0419.
MS 2896, Juvenile Justice Children, is revised to incorporate procedures for
transferring DJJ cases previously in Vol I, MS 0172.

                                      Volume IVA

The Table of Contents is revised to add the following manual sections:

MS   1235,   Disclosure of Information;
MS   1237,   Vendor Billing/Service Information;
MS   1240,   KYHealth Card;
MS   1245,   Nonreceipt of KYHealth Cards
MS   1340,   Kentucky Health Partnership Managed Care;
MS   1342,   Managed Care Definitions;
MS   1344,   KYHealth Card and Managed Care Card;
MS   1346,   Worker Responsibilities/Beneficiary Groups;
MS   1348,   Guaranteed Coverage;
MS   1373,   Taking the Application;
MS   1378,   Caseload Responsibility;
MS   1425,   Case Number Assignment;
MS   1475,   Assignment of Caseload Codes;
MS   1476,   Caseload Code and County of Residence;
MS   1545,   Out-of-State Inquiries;
MS   1547,   SSI Recipients Moving into Kentucky;
MS   1549,   Out-of-State Request for Termination of Medicaid;
MS   1562,   SSN Applications;
MS   1564,   Failure to Comply with Enumeration;
MS   1566,   Enumeration Good Cause Criteria;
MS   1568,   Use of the SSN;
MS   1570,   Citizenship and Identity Requirements for MA Programs;
MS   1575,   MA Case Processing for Citizenship Verification;
MS   1577,   Criteria for Qualified Aliens;
MS   1578,   Time-Limited Eligibility; and
MS   1579,   Extension of Time-Limited MA.

MS 1235, Disclosure of Medicaid Information, is created to incorporate the Medicaid
procedures from Vol. I, MS 0126.

MS 1237, Vendor Billing/Service Information, is created to incorporate procedures
from Vol. I, MS 0459. The material is revised to incorporate current referral
information.

MS 1240, KYHealth Card, is created to incorporate procedures from Vol. I, MS 0450.
The material is revised for clarity.

MS 1245, Nonreceipt of KYHealth Cards, is created to incorporate procedures from
Vol. I, MS 0456.

MS 1340, Managed Care Enrollment, is created to incorporate procedures from Vol.
I, MS 0350.

MS 1342, Managed Care Definitions, is created to incorporate procedures from Vol. I,
MS 0351. The material is revised to reflect the current name for the Centers for
Medicare and Medicaid Services (CMS).
MS 1344, KYHealth Card and Managed Care Card, is created to incorporate
procedures from Vol. I, MS 0352.

MS 1346, Worker Responsibilities/Beneficiary Groups, is created to incorporate
procedures from Vol. I, MS 0353.

MS 1348, Guaranteed Coverage, is created to incorporate procedures from Vol. I, MS
0355.

MS 1373, Taking the Application, is created to incorporate procedures from Vol. I,
MS 0095.

MS 1378, Caseload Responsibility, is created to incorporate procedures from Vol. I,
MS 0155. The material is revised for clarity.

MS 1425, Case Number Assignment, is created to incorporate procedures from Vol.
I, MS 0153. The material is revised to reflect that PA-62 procedures apply only to A,
B, and D cases.

MS 1440, Case Record, is revised to incorporate procedures from Vol. I, MS 0159,
and for clarity.

MS 1475, Assignment of Caseload Codes, is created to incorporate procedures from
Vol. I, MS 0174. The material is revised to reflect current caseload/security request
procedures.

MS 1476, Determining Caseload Code and County of Residence, is created to
incorporate procedures from Vol. I, MS 0175. The material is revised for clarity and
to delete the reference to the Human Services Transportation Delivery System.

MS 1510, Notice of Adverse Action, is revised to incorporate procedures from Vol I.
MS 0553.

MS 1545, Out-of-State Medicaid Inquiries, is created to incorporate procedures from
Vol. I, MS 0462. The material is revised for clarity.

MS 1547, SSI Recipients Moving into Kentucky, is created to incorporate procedures
from Vol. I, MS 0458. The material is revised for clarity and to replace the acronym
OSB with MSBB.

MS 1549, Out-of-State Request for Termination of Medicaid, is created to incorporate
procedures from Vol. I, MS 0457. The material is revised to reflect current telephone
contact information.

MS 1562, SSN Applications, is created to incorporate procedures from Vol. I, MS
0656. The material is revised to add the SSA website address, to delete references
to obsolete SSA forms and procedures, to replace E-7 references with KVETS
procedures, and to reflect that SSA now requires face-to-face interviews for first
time SSN applications for individuals age 12 or older.

MS 1564, Failure to Comply with Enumeration, is created to incorporate procedures
from Vol. I, MS 0653.
MS 1566, Enumeration Good Cause Criteria, is created to incorporate procedures
from Vol. I, MS 0659. The material is revised for clarity.

MS 1568, Use of the SSN, is created to incorporate procedures from Vol. I, MS 0662.

MS 1570, Citizenship and Identity Requirements for MA Programs, is created to
incorporate procedures from Vol. I, MS 0625.

MS 1575, MA Case Processing for Citizenship Verification, is created to incorporate
procedures from Vol. I, MS 0626.

MS 1577, Criteria For Qualified Aliens, is created to incorporate procedures from Vol.
I, MS 2000. The material is revised to incorporate the Federal policy clearance that
Afghan aliens who are exempt from the 5 year waiting period are subject to an 8
month waiting period.

MS 1578, Time-Limited Eligibility, is created to incorporate procedures from Vol. I,
MS 2075. The material is revised to clarify that time-limited recipients are to be
placed in separate cases from ongoing eligible household members.

MS 1579, Extension of Time-Limited MA, is created to incorporate procedures from
Vol. I, MS 2085.

MS 2700, Spend Down Medical Expense Verification, is revised to reflect the change
in Medicare terminology from Explanation of Benefits (EOB) to Medicare Summary
Notices (MSN).

MS 2710, Spend Down Medical Expense Restrictions, is revised to reflect the change
in Medicare terminology from Explanation of Benefits (EOB) to Medicare Summary
Notices (MSN).

                                     Volume VI

The Table of Contents is revised to delete MS 1500, SSN Verification, and MS 1505,
SVES, as these sections are obsolete with the issuance of this transmittal letter.

MS 1500, SSN Verification, Is obsolete as these procedures are incorporated into
Vol. IV and Vol. IVA.

MS 1505, SVES, is obsolete as these procedures are no longer in effect.

                                Volume X

The Table of Contents is revised to delete MS 99631 and MS 99613 as they are
obsolete.

MS 99613, OMU No. 03-10, is obsolete as both Gallatin and Hancock Counties are
now KenPAC.

MS 99631, OMU NO. 03-23, is obsolete as the KenPAC Provider Change procedures
are incorporated into the KenPAC sections created in Vol IV.

                                                     Patricia R. Wilson, Commissioner

								
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