All Medicaid Programs |
Obsolete Policy |
Effective Date: July 1, 2019 - December 31, 2019
Verifying eligibility for the TAM coverage group (346) is based upon the different coverage groups and subgroups. Use the table below to determine the verification process and which verification is needed at application and review.
Group |
Subgroup |
At Application |
At Review |
Verification |
Chronically Homeless |
12 Month Homeless |
Has to be meet the homeless or supportive housing criteria. |
Has to still meet the homeless or supportive housing criteria. |
HMIS or Form 42A (questions 1 and 2) |
Supportive Housing |
Form 42A (questions 1 and 3) |
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Justice Involved |
Involved with a Drug or Mental Health Court |
Has to be currently involved with the court. |
Has to still be currently involved with a court. |
Form 43A (question 2) |
Released from jail or prison |
Has to meet the treatment criteria and the application must be submitted within 60 days from date of release. |
No verification needed.
If there is a break in coverage, ‘At Application’ criteria applies. |
Form 43A (question 1) |
|
Discharged from State Hospital - Criminal Charge |
Has to meet the State Hospital criteria and the application must be submitted within 60 days of being discharged. |
No verification needed.
If there is a break in coverage, ‘At Application’ criteria applies. |
Form 44A (question 1) |
|
Needing Treatment |
6 Month Homeless |
Has to meet the homeless criteria. |
Has to still meet the homeless criteria. |
Form 42A (question 4) |
Discharged from State Hospital - Civil Commitment |
Has to meet the State Hospital criteria for Needing Treatment and the application must be submitted within 60 days of being discharged. |
No verification needed.
If there is a break in coverage, ‘At Application’ criteria applies. |
Form 44A (question 2) |
|
Receiving General Assistance (GA) |
Has to meet the GA criteria. |
Has to still meet the GA criteria. |
Form 45A (Substance use or mental health disorder)
Form 20 (Substance use disorder only)
Form 1GA or 20M (Mental health disorder only)
Other medical evidence by a licensed practitioner
Note: Form 1, 20 and 20M are only valid to verify a substance use or mental health disorder for 12 months from date of completion.
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