All Medicaid Programs

Obsolete Policy

 

Obsolete 0317 - 801-1 Case Record Requirements

Effective Date: January 1, 2014 - February 28, 2017

Previous 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.