Summer is in full swing, and every beach bag needs a few small essential items. This month, we also have a few essential items to keep you equipped to assist consumers.
1. Be sure to clear your cache!
If you create an application for a consumer and need to go back and change the name before you submit it, you should clear your cache before you make the change. This will ensure the Master Person Identifier (MPI) service is called, and the correct MPI can be assigned to the consumer.
2. Speaking of multiple MPIs . . .
With Release 26, Maryland Health Connection began applying some additional criteria when consumers apply for coverage to prevent duplicate enrollments. HBX will deny coverage when an existing consumer with active coverage is identified to be applying for coverage through another initial application. When the consumer applies for coverage, the system will check if the consumer has a pending or active enrollment in Medicaid, the Maryland Children’s Health Program, Maryland Children’s Health Program Premium or Assisted Qualified Health Plan based on the Social Security number (SSN) or MPI. To determine if a consumer has coverage in more than one application, use application history and search by SSN. If there are multiple applications, they will be listed by logical application series. Then select “details” to find the latest enrolled application. Any changes should be made on the latest enrolled application. See Job Aid in the learning management system (LMS) for additional details.
3. Hourly wages
You may have noticed if you try to enter an applicant’s salary at an hourly rate, you get an error message “please enter hours numbers per week,” but the number of hours aren’t accepted by HBX. Until the adjustment is made, please calculate hourly income as weekly or monthly income as a submission.
4. Grace period
As we run the 90-day QHP batch, consumers who failed to provide an income verification checklist (VCL) might find advance premium tax credit (APTC) stripped. A change report with an income verification document will restore APTC if the household is otherwise eligible, but the effective date is the following month. For now, consumers must pay the full bill as invoiced. It’s also important for consumers to understand that if they lose APTC, the grace period also reduces from 90 to 31 days.
5. Transitional Medical Assistance (TMA)
Under certain conditions, a consumer who is eligible for TMA may lose eligibility after a second change report is completed. A resolution will be deployed late 2019. For now, these cases should be escalated along your usual escalation pathway for a data fix or override.
6. Retro Medicaid
HBX is now able to process retro Medicaid with change reports, except for consumers who have a gap in coverage. For example, if HBX sees an initial app from 2017, it is not recognizing the consumer who is disenrolled in 2018, then reapplying for coverage in 2019, as a consumer who is eligible to apply for retro. This can be seen when clicked on the previous months to complete the retro. The HBX will flash and remain on the same screen. A resolution will occur early 2020. Until then, these cases must be escalated for a data fix.