Medicaid Policy                                                                 

825-3 Preparations for Referral for Investigation or Calculation

Effective Date: March 1, 2023

Previous Policy

 

Introduction

Before you refer an overpayment or understatement of liability for an investigation or a calculation, you must:

1.    Consider the client’s eligibility for other medical assistance programs (827), and

2.    Close the medical assistance if the client is open for but not currently eligible for any medical assistance program (827).

 

Instructions for programs that were open during the Covid-19 Public Health Emergency (PHE)

 

No overpayments can be assessed for any period during the PHE. Overpayments may be assessed for ineligible programs after April 2023.

·       Programs can only be assessed after a full review is complete.