Case Manager Medically Dependent Children Program Handbook

Section 3000

Eligibility Determination and Individual Plan of Care Development
Table of Contents

3100
Eligibility Determination
3110
Medicaid Eligibility for the Initial Application
3110.1
Medicaid Buy-In and Medicaid Buy-In for Children
3110.2
Coordination of Disability Determinations
3111
Qualified Income Trust (QIT)
3111.1
Determination of Copayment
3111.2
Refusal to Participate
3111.3
Refund of Copayment
3111.4
Refusal to Pay the Copayment
3120
Medical Necessity
3121
Medical Necessity Determination for Applicants Residing in Nursing Facilities
3122
Medical Necessity Determination for Applicants Recently Discharged from Nursing Facilities
3123
Medical Necessity Inquiry through the Online Portal
3130
Individual Plan of Care Development
3130.1
Setting Funds Aside in the IPC
3130.2
Coordinating IPC Development with the Provider
3131
Determining Cost Effectiveness
3132
The Individual Plan of Care Service Initiation Date and Effective Period
3132.1
Determining the Number of Weeks in the Initial IPC Period
3133
Notifying MEPD of Approved IPC and MN
3134
Other Resources and Services
3135
Coordinating with IDD Services During the Development of the Initial IPC
3135.1
Access to the CARE System
3200
Personal Care Services (PCS)
3200.1
PCS Data Reports
3200.2
Using the PCS Data Reports
3210
Procedures for the MDCP Applicant Who Receives PCS
3220
Procedures for the MDCP Applicant Who Does Not Receive PCS
3230
FMS for the MDCP Applicant Accessing CDS
3240
Coordination of Services in the MDCP IPC and Personal Care Assessment Form
3300
Targeted Case Management (TCM)
3300.1
Coordination of TCM and MDCP Services
3400
Reserved for Future Use
3500
Money Follows the Person Option
3500.1
Individuals Without Medicaid
3500.2
Individuals With Medicaid
3510
Individuals Currently Residing in a Nursing Facility
3520
Limited Nursing Facility Stay for Medically Fragile Individuals
3520.1
MFP Procedures for Requesting a Limited Nursing Facility Stay
3520.2
Case Manager Receipt of Form 2406
3520.3
Regional Nurse Approval
3520.4
Submission of Form 2406 to the DADS Physician
3520.5
Determination of Medical Fragility by the DADS Physician
3520.6
Initial Home Visit for Individuals Approved for a Limited Nursing Facility Stay
3520.7
Coordination of the Limited Nursing Facility Stay
3530
Money Follows the Person Demonstration (MFPD)
3530.1
MFPD 365-Day Entitlement Period
3540
Closing NF Authorizations for Individuals Transitioning to Community Services
3550
Accessing Relocation Services