Department of Human Services: Chapter 3: Sections 3.1 thru 3.3
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Department of Human Services

 
 
 

IMA POLICY MANUAL
PART III:  APPLICATION PROCESSING
 
CHAPTER 3:  APPLICATION DISPOSITION

INTRODUCTION  3.1
 
There are two application dispositions:  approved and denied.
 
This chapter addresses both types of dispositions, but the majority of the chapter concentrates on denied applications.
 

LEGAL AUTHORITY  3.2
 

AREA/TOPIC  DISTRICT  FEDERAL
Application Withdrawal    FS:  7 CFR 273.2
Application Denial 
TANF:  D.C. Code 4-205.26; 4-205.27; 4-205.51; 4-210
 
GC:  See TANF and D.C. Code 4-205.5a
MA:  42 CFR 431.206; 431.220; 435.911-912
 
FS:  7 CFR 273.2
 

APPROVALS  3.3 
 
MA 
If all non-financial and financial conditions of eligibility (see Part IV:  Non-Financial Eligibility and Part VI:  Financial Eligibility) are met, the SSR shall notify the applicant of eligibility via letter within 45 days of the date of application.
 
IMA shall  inform DOH about the applicant's eligibility.  DOH will inform the applicant if s/he must enroll in a managed care program.
 
The applicant will receive his/her MA card through the mail.
 
If the applicant is ineligible during the month of application but becomes eligible before the application is denied, the SSR shall approve the application for the month in which the applicant meets the eligibility requirements.
Example
Ms. Parks, age 67, applies on January 3 for Medicaid based on age and income.  At the time she applies, she fails to meet the asset test, but on January 15, she calls to say that her assets have been depleted below the asset limit because she paid a past due credit card bill. The SSR has not yet denied her application for Medicaid.  Ms. Parks will now be approved for Medicaid effective January 1.
TANF 
If all non-financial and financial conditions of eligibility (see Part IV:  Non-Financial Eligibility and Part VI:  Financial Eligibility) are met, the SSR shall approve the application and notify the applicant of the approval, the amount of assistance, and eligibility for MA (See Chapter 12: Categorical Eligibility in Part IV).  If the applicant is eligible for FS a separate notice will be sent.
 
 If the applicant is ineligible during the month of application but becomes eligible before the application is denied, the SSR shall approve the application for the first month in which the applicant meets all eligibility requirements.
 
GC
See TANF
 
FS
If all financial and non-financial eligibility conditions are met (see Part IV:  Non-Financial Eligibility and Part VI:  Financial Eligibility), the SSR must notify the household in writing of its eligibility and the level of benefits the household will receive.  All applications must be screened for expedited services (see  Section 4.4:  Screening Applications in this Part).
 
The SSR must also send eligible households written notice of their requirement to report changes. For households under Simplified Reporting rules, the SSR shall send ACEDS notice F722: "Notice of Simplified Reporting." For households under Standard Reporting rules, the SSR shall send ACEDS notice F723: " Standard Reporting Notice." (See Part VII, Section 5.3.1: Standard Reporting and Section 5.3.2: Simplified Reporting.)