Show:
9 Months and the Fun Begins
Tots, Teens, and 'Rents...Oh My!
Help! I've Fallen and I Can't Get Up
Three Blind Mice
Bullets Review / Clarence's Corner
100
This is the program that expands medical coverage to uninsured pregnant women who are ineligible for Medicaid and have income in excess of the Medicaid limits, but whose family income is less than or equal to 200% of the federal poverty level (FPL).
What is "FAMIS MOMS"?
100
What are the resource limits for Medically Needy F&C Classification?
What are "$2000 for one person, $3000 for two persons, and $100 for each additional person in the FU or BU"?
100
This is: --30 consecutive days of care in a medical institution (such as a nursing facility), Medicaid Community-Based Care (CBC) services, or a combination of the two. --Or a signed hospice election that has been in effect for 30 consecutive days.
What is "Institutionalization"?
100
When an individual receives an asset (real or personal property), it is counted as __________ in the month it is received and as ___________ the following month.
What is "income" and "a resource" (in that order)?
100
Name the EAS note type that must be in EVERY account, even add loads. It will be used for our referral count.
What is "EAS pending" or "6086"?
200
This categorically needy covered group includes a child that was born to a mother who is found eligible for Medicaid as medically needy or meets spenddown effective on or before the date of the child’s birth.
What is "Child <1"?
200
Give the formula you would use to calculate earned income for Joe (parent in home) who gets paid weekly. In the month of his application, he made $220, $210, $215, and $217.
What is "$220 plus $210 plus $215 plus $217. Divide sum by 4 to get average. Multiply result by 4.3 for monthly income. Subtract $90 disregard"?
200
Information must be obtained from all Medicaid applicants/recipients who require LTC services about transfers of both income and resources that occurred during THIS TIME PERIOD before the Medicaid application date.
What is "five years"?
200
True or false. A QMB-only Medicaid applicant can request retro coverage. (Can you explain the difference between QMB and SLMB? Sorry, no extra points awarded.)
What is "false"? QMB and SLMB are both types of Medicaid for Medicare Beneficiaries. QMB will pay the Medicare deductible and co-insurance in addition to the premium, whereas SLMB pays the Medicare Part B premium.
200
This is the procedure for completing FAPs on Medicare patients. Name the process. To get credit for this question, you must also list any note type/billing indicator used.
What is "Complete the paper form including a signature and send it to Kathleen Dooley. Set the EAS Accept-LTC note type (6073). DO NOT SET THE BILLING INDICATOR, as the account does not need to load to FACS"?
300
This is the amount of time that a woman meets definition of “pregnant woman” after her pregnancy ends.
What is "sixty days following the last day the woman was pregnant and continues to be met until the last day of the month in which the 60th day occurs"?
300
True or False. In West Virginia, Poverty-Level Children ages 1-18 are evaluated at the same income level as Virginia MI income limits (133% FPL).
What is "False"? Ages 1-5 are evaluated at the same income limits as Virginia MI limits (133% FPL), but ages 6-18 are evaluated at 100% FPL (same as the SLH column on VA Income Chart).
300
For a Long Term Care Medicaid instutionalized patient with a community spouse, the resource assessment is based on this date.
What is "the FIRST MOMENT OF THE FIRST DAY OF THE FIRST MONTH of the first continuous period of institutionalization that began on or after September 30, 1989"?
300
When considering retirement funds, you can exclude this amount from the value of the retirement funds.
What is "the amount available to an individual after penalty deduction for early withdrawal"? Note: any taxes due are NOT excluded.
300
An individual who has been convicted of Medicaid fraud is ineligible for Medicaid for this period of time.
What is "12 months beginning with the month of fraud conviction"?
400
True or False. West Virginia has a program known as Pregnant Women West Virginia CHIP, which covers pregnant women from 150%-200% FPL and does not evaluate resources.
What is "False"? West Virginia CHIP is a program for children from birth to age 19.
400
Sally is 26 and lives with her 24-year-old cousin Betty and Betty's 2-year-old daughter. Betty has no income and attends GED classes. Sally also has no income. She babysits Betty's daughter while Betty is in school. Sally is not pregnant, blind or disabled. Explain how Sally is eligible for Medicaid.
What is "Sally is considered 'essential to the well-being of a child in the household' or EWB"? The EWB must not meet any other covered groups and provides a service to someone who is eligible for Medicaid in the CNNMP LIFC covered group. The EWB is in a separate family unit but must still fall under income limits for LIFC.
400
This is the spousal resource standard for Long Term Care Medicaid.
What is "$21,912"?
400
When a person's real property makes him/her ineligible for Medicaid, he or she may become eligible by demonstrating a reasonable effort to sell. Name two ways he/she can immediately become eligible and the proof required.
What is "listing property with realtor at tax assessed value" and "providing letters from two realtors who refuse to list because they do not think property will sell at tax assessed value"? (Will also accept: What is "individual privately advertises property for 90 days"?)
400
When completing a FAP on self-employed patients, use this specific figure for annual income.
What is "the amount listed under Gross Receipts on Schedule C, Profit or Loss from Business, from the most recent tax return"?
500
Name the circumstance in which a person may be eligible for retroactive coverage under FAMIS.
What is "a newborn born in the last three months"? (No other person is eligible for retroactive coverage in the FAMIS program.)
500
This is a Title XXI Program for North Carolina that covers children ages 6-19. This program is for children not eligible for full Medicaid benefits, the income limit is between 100% and 200% FPL, and fees may be required.
What is "North Carolina Health Choice"?
500
The transfer of the home property does not affect eligibility when transferred to the individual's son or daughter who resided in the home and provided care to the individual during the entire two-year period before the individual became an institutionalized individual. Name the 3 documents needed for verification.
What is "statement from a physican, statement from a third party, and statement from the son/daughter"? Follow manual for specific criteria necessary.
500
True or False. In West Virginia, in a home with dependent children, a parent who is temporarily incapacitated and who exceeds the income limits for AFDC-Related Medicaid may become eligible through a spenddown if he/she meets the asset test.
What is "True"? The period of incapacitation (what we casually refer to as 'temporary disability') must be 30 days or longer. For SSI-related Medicaid and Medicaid Work Incentive or M-WIN (disabled individuals between 16 and 65 who are employed), the determination for disability matches SSA's (i.e. individual is unable to do SGA for minimum of 12 months).
500
If a patient received Social Security disability benefits and was in jail for less than 12 months, this is needed to restart payments.
What are "the release papers and the SSA sheet of updated information (new address etc.)"?