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A change in medical or functional condition must be reported. An improvement in the customer’s medical condition may affect the outcome of a Preadmission Screening (PAS) reassessment for ALTCS.
For a medical improvement that affects the Disability Determinations Services Administration (DDSA) disability determination for SSI-MAO or Freedom to Work (FTW) see MA1502I.
When the PAS reassessment determines the customer ... |
Then... |
Is medically ineligible |
The customer’s ALTCS eligibility is discontinued and the customer is screened for other Medicaid eligibility. |
Has improved medically or functionally and is no longer at risk of institutionalization at a nursing facility (NF) or intermediate care facility (ICF), but requires a lower level of long term care |
The customer is transferred to the ALTCS Transitional program. |
Term |
Definition |
Preadmission Screening (PAS) |
PAS is ALTCS’ method of determining whether a customer is medically eligible for the ALTCS program. The PAS process also is used to determine disability for customers under age 65 who have not been determined to have a disability or blindness by DDSA. |
ALTCS Medical Eligibility staff enter the PAS reassessment results in HEAplus.
This applies to the ALTCS and FTW-ALTCS programs.
Changes must be reported as soon as the event becomes known. Unanticipated changes must be reported within 10 calendar days of the date the change occurred.
Program |
Legal Authorities |
ALTCS FTW - ALTCS |
42 USC 1396(a)(10)(A)(ii)(V) and (XVI) 42 CFR 435.916 AAC R9-28-306 and 307 |