GIS 11 MA/002: Chafee Auto Renewal Process - Upstate

This General Information System (GIS) message is being issued to provide information to upstate local departments of social services (LDSS) regarding e Chafee youth automated renewal process.

As discussed in 09 OHIP/ADM-1, effective January 1, 2009, children under age 21 who were in foster care on or after their 18th birthday are covered by Medicaid without an income or resource test. As a result of this change, Medicaid is available to children upon final discharge from foster care until their 21st birthday. The child must continue to live in New York State to receive Medicaid.

As these children are entitled to ongoing Medicaid through the end of the month of their 21st birthday, the renewal process has been simplified and automated through WMS for case type 20 youth meeting the Chafee criteria. This simplified renewal is a one page document with a cover letter that is mailed through CNS. It is automated for youth over age 18 and under age 21 with a Chafee indicator and active in a single individual case type 20. The mailed Chafee renewal is considered a "passive renewal", as the youth has to only return the form if he or she has moved out of State, has an address change, or there is new or terminated health insurance. These cases may be closed by the LDSS if the child has moved out of New York State or is deceased. However, if the Chafee child turns 21 during renewal, the "Auth To Date" and "MA Coverage To Date" are set to the end of the month of the recipient's 21st birthday. At that point, the LDSS should redetermine eligibility based on regular Medicaid rules.

On the first full weekend of the month, WMS produces a BICS report, "WINR4007-Chafee Recert Report", which lists cases that have been sent the CNS renewal cover letter and update form. The report contains the case number, case name and CIN for the Chafee recipient.

For cases in active status, WMS will automate a one year authorization extension and extend Medicaid coverage for one year, or until the end of the month in which the youth turns 21, on the last weekend of the month that the case is due to expire. An authorization (3209) will not be produced but the transaction will be reflected in the WMS Transaction Disposition History (WINQ08) with a unique authorization number of 9XXXXMA2 (X will be a letter or number), a system generated reason code of "863 - Chafee Recert" and the Office/Unit/Worker = CHF/RECRT/NYDOH. However, an automated recertification will not be processed for a Chafee case due to expire that has an existing pending transaction, and will be reported as a failed update.

Cases that meet the criteria for an automated recertification transaction for renewal will be reported on the BICS report "WINR4008 - Chafee Recert Disposition Report" which will indicate the new authorization FROM and TO dates. Failed updates will be listed first on the WINR4008 and will require LDSS review and appropriate action. The LDSS must also review authorization TO dates to determine individuals turning 21. Prior to the end of the month in which a Chafee child turns 21, the LDSS must send the DOH-4287, "Continuing Your Medicaid and/or Family Health Plus Benefits." Please note that the LDSS also receives notification of this milestone through the system generated AFA code 106 - Individuals Turning 21 Years. Modifications to the renewal process for Chafee youth turning 21 are being pursued and LDSS will be advised when changes are made.

Below are examples of the time frames for case type 20 single active Chafee youth under 21 years old:

With an Auth TO Date:	CNS Mailer Sent:	Automated Recert Processed:	New Auth FROM and TO Date:
2/28/11	3rd weekend in December	Last weekend in February	3/1/11--- 2/28/12
7/31/11	3rd weekend in May	Last weekend in July	8/1/11---- 7/31/12

This process began in October for cases that expired 12/31/10, and will be an ongoing monthly process.

Please note, when the LDSS becomes aware of a move by a Chafee child within New York State, the case is to be continued in the first county until transferred to the new county via the Luberto process.