All Medicaid Programs |
Obsolete Policy |
Effective Date: November 1, 2021 - September 30, 2023
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 meet the homeless or supportive housing criteria. |
Has to still meet the homeless criteria. New referral form is required. |
HMIS or Form 42A (question 1) |
|
6 month homeless |
From 42A (question 2) |
|||
|
Domestic violence (DV) |
Had to be a victim of DV |
Has to still meet the DV criteria. New referral form is required. |
Form 42A (question 3) |
|
|
Supportive Housing |
Has to meet the homeless or supportive housing criteria. |
Has to still meet the supportive housing criteria. New referral form is required. |
Form 42A (question 4)
|
|
|
Justice Involved |
Released from jail or prison and has complied with SUD treatment while incarcerated. |
Has to meet the treatment criteria and the application must be submitted within 60 days from date of release. |
No new referral form needed unless there is a break in coverage, at which time the ‘At Application’ criteria would apply. |
Form 43A (question 1) |
|
On parole or probation |
Has to be on parole or probation |
Has to still be on parole or probation.
New referral form is required. |
Form 43A (question 4) |
|
|
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. New referral form is required. |
Form 43A (question 2) |
|
|
Court ordered substance use or mental health treatment |
Has to be currently court ordered for treatment. |
Has to still be currently court ordered for treatment. New referral form is required. |
Form 43A (question 3) |
|
|
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 new referral form needed unless there is a break in coverage, at which time the ‘At Application’ criteria would apply. |
Form 44A (question 1) |
|
|
Needing Treatment |
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 new referral form needed unless there is a break in coverage, at which time the ‘At Application’ criteria would apply. |
Form 44A (question 2) |
|
Receiving General Assistance (GA) |
Has to meet the GA criteria. |
Has to still meet the GA criteria. AND New referral form is required unless a substance use or mental health disorder has been verified in the last 12 months. |
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. |