All Medicaid Programs |
Obsolete Policy |
Previous Policy
Improper medical eligibility can occur when:
an individual receives medical coverage he is not eligible for,
a spenddown or MWI premium amount is not calculated correctly,
a Prenatal Asset co-payment is not calculated correctly,
a contribution to cost of care for long-term care services is not calculated correctly,
a person receives continued benefits pending a fair hearing or SSA appeal and the outcome of the hearing or appeal is still a denial, or
a person receives conditional benefits under an undue hardship decision, and fails to take all required actions to regain or access assets.
This includes overstated and understated liabilities.