Applications-Client is determined eligible for non-institutional CNP coverage
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Applications-Client is determined eligible for non-institutional CNP coverage


Revised May 18, 2012



Applications-Client is determined eligible for non-institutional CNP coverage

Process application following regular Medicaid processing guidelines.  The L22 program is not used if client is eligible for another non institutional CNP program and living outside a medical institution.

 

(The L22 medical coverage group is always used when a client is residing in a medical institution 30 days or more for a Hospice program when the client is aged/blind or disabled).

 

Code the hospice provider number on the INST screen in ACES.  ACES uses the provider number to automatically issue copies of the award letter to the hospice agency. Ensure that the provider also receives copies of any pending letters sent to the client so they can assist the client in gathering any missing verifications. 

 

On the INST screen code Hospice on the HCB Service section with the Hospice service start date. Indicate “MA” as approval source. 

 

Using the13-746DSHS/Medicaid hospice notification, FAX a response to the Hospice Agency indicating the client is receiving CNP Medicaid and has no participation requirement (the only time a client may have to pay toward the cost of their care is when using the C01 institutional hospice rules).  The DSHS 13-746 has instructions describing how to complete the form.     

 

Document in the narrative that the CSO response portion of the DSHS 13-746 has been faxed back to the hospice agency.

 

Follow necessary Equal Access (EA) procedures.  This is formerly known as Necessary Supplemental Accommodation (NSA).

 

ACES instructions

Modification Date: May 18, 2012