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All Medicaid Programs |
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Obsolete Policy |
Creating a case record
Create a case record for each application received.
The case record must include:
Date of application and signed application form
Action taken on the application
Reason for decision
Benefit effective date
Information and verifications required to determine initial and on-going eligibility,
Information received through exchanges from other sources required under law as described in 751-1.
Reason for denial or closure
Case Maintenance
Re-certification records must include:
Review forms if returned by the recipient (may not always be needed).
Electronic data match information or other verifications required for re-certification.
Actions taken to complete reviews.
Decision made on review and reason.
Record of changes must include:
Change reports including date report was made.
Electronic data match information or other verifications of changes
Actions taken on changes.
Retention of records
In general, maintain all information in an individual’s eligibility records a minimum of seven years. If the information is relevant to current eligibility, retain the information as long as it relates to the individual's eligibility.
Maintain the following verifications and information with a long-term status (formerly referred to as permanent verifications) :
Identity verifications
Citizenship documents
Alien records
Social Security numbers
Trusts
Medical Review Board records, unless client has qualified for SSI/SSA benefits or has turned 65.
Assessment of Assets
Applications and review forms
The original application for the current span of eligibility will be kept as a long-term record if eligibility has not been interrupted for more than 3 months.
All other applications and reviews will have a five year minimum purge date.
Other verifications
Purge records that are more than five years old that no longer pertain to current eligibility. (e.g. income and asset verifications)
Closed cases
Purge all records from cases closed or denied for more than five years, including long-term verifications.