All Medicaid Programs

Obsolete Policy

 

Obsolete 0414 - 392 TB Positive Group

Policy Effective May 1, 2006 - March 31, 2014

 

Eligibility for Other Medicaid Coverage Groups

If eligible for Medicaid without spending down, approve the other Medicaid program.

If not eligible for Medicaid without spending down, continue with the eligibility tests for this program.

TIP

Medical Condition

Clients must be infected with tuberculosis or be suspected of being infected with tuberculosis.

Other Medicaid Requirements

The general eligibility requirements apply.  Clients must:

Income

Apply same income disregards and exemptions that we apply to disability Medicaid.  Client is income eligible only if countable income is equal to or less than SSI payment.

Resources

Apply same asset exemptions that we apply to disability Medicaid.  Client is asset eligible only if countable assets are equal to or less than Medicaid asset level: $2000.00

Restriction on Medical Services

This is not an eligibility requirement.  However, we must make sure that we pay only for the authorized TB services related to the tuberculosis.   Although clients infected with TB who are eligible under other Medicaid programs receive the Medicaid Scope of Services, clients eligible for this program receive a more limited scope.

 

Section 1902(z) (2) describes the scope of services for this program:

  1. Prescribed drugs

  2. Physicians’ services and services described in section 1905(a)(2)

  3. Laboratory and X-ray services (including services to confirm the presence of infection)

  4. Clinic services and federally-qualified health center services

  5. Case management services (as defined in section 1915(g)(2))

  6. Services (other than room and board) designed to encourage completion of regimens of prescribed drugs by outpatients, including services to observe directly the intake of prescribed drugs.

However, to be covered, these services must be related to the treatment of tuberculosis.