As a result of the Thibeault Settlement Agreeement, the Department has agreed to provide retroactive relief to certain current TAFDC recipients and a notice to certain former TAFDC recipients whose disability application had been previously denied by HealthPro for reasons other than failing to meet the requirements of the Initial Appointment for Medical Treatment (IAMT) letter...

As a result of the Thibeault Settlemetn Agreeement, the Department has agreed to provide retroactive relief to certain current TAFDC recipients and a notice to certain former TAFDC recipients whose disability application had been previously denied by HealthPro for reasons other than failing to meet the requirements of the Initial Appointment for Medical Treatment (IAMT) letter...

In April of 2003 the provisions of HIPAA went into effect. These federal privacy provisions protect patients' medical records and other health information provided to health plans, doctors, hospitals, pharmacies and other health care providers. These provisions also provide patients with access to their medical records and more control over how their personal health information is used and disclosed.

The Department recently automated the flow of information to the Disability window with information received from PRO (DES) and SSA tape files in an effort to streamline the disability process. Field Operations Memo 2004-1 (dated January 30, 2004) told TAO staff about the automated process.

This field Op Memo addresses three issues called into the System's Help Desk regarding the automated disability process.

The automated process on the Disability Window is being enhanced with the August mailings of Medical Reports and Disability Supplements from BEACON. This Field Operations Memo tells TAO staff about the enhancements as well as two new reports on Actuate to help AU Managers track the AUs sent a Medical Report and Disability Supplement.

The Children’s Behavioral Health Initiative (CBHI) is the result of the decision in the Rosie D. et. al. v. Patrick lawsuit.  It is a joint collaboration between the Executive Office of Health and Human Services (EOHHS) and MassHealth to implement the decision and to take additional steps to promote the behavioral health of MassHealth-enrolled children under the age of 21.  As part of the CBHI, MassHealth is improving its education and outreach to MassHealth members, providers, members of the public, and private and state agency staff who come into contact with MassHealth-enrolled children under the age of 21 about Early Periodic Screening, Diagnosis and Treatment (EPSDT) services as well as other preventive care services provided through MassHealth.  This memo contains details about behavioral health screening services.

Procedures for case workers to follow if a recipient with a nonpresumptive disability exemption request (second or later request) is found disabled. [Ed. note: Good Cause Medical forms can be used to excuse people in this position from required activities while the exemption requests are pending.]

Explains DES requirements for medical release forms, including that every individual provider at a particular clinic must be listed separately on a separate form. Case workers are responsible for contacting clients when additional release forms are needed. Missing or incorrectly completed release forms should not delay case worker processing of the disability claim or an application for benefits.

TFADC: notice of second disability denial; TAFDC: verifying domestic violence for dv waiver purposes-- including caseworker responsibilities; TAFDC: domestic violence waivers of the work requirement, recipients' right to apply for dv waivers despite caseworker thinking they do not qualify.

TAFDC: child support for child on SSI not countable; TAFDC: disability exemption request counts as first request if first in 5 year clock cycle; EA: no school requirement, eligibility for pregnant women at any stage of pregnancy.

SSI Special Benefits for disaster and moving; TAFDC exemptions in two-parent families where one parent is disabled; FS work requirement and school employees over summer vacation; transportation and lodging as part of excess medical deductions for FS.

TAFDC: recipients enrolling in community college near end of time limit eligible for child care and transportation but may not get extension; time clock in two-parent households and households where one parent moves out; accessing EBT cards out of state; FS: immigrant work quarters; TAFDC: eligibility for pregnant women with family cap date and no children living with them; TAFDC: time clock for recipient denied disability exemption; TAFDC: exemptions for parent with child under two who has gotten waiver or exception to family cap rule.

TAFDC: start of 60 month time clock; TAFDC: sanctioning of dependent child teen not meeting ESP requirements; TAFDC: teen parent in custody of DSS; TAFDC: how to adjust time clock upon approval of disability exemption.

Revised December 13, 2005. This is the revised version.

Revised January 19, 2006. This is the revised version.

Revised March 1, 2006. This is the revised version.

Revised April 24, 2006 to comply with Thibault litigation. This is the revised version.

This document was revised on March 1, 2006.  The revised version is posted here, as it replaces the one written in 1998.

This PS is no longer in effect; it was superseded with the revision of Procedural Standard 98-3 dated January 19, 2006.

This memo was revised June 2, 2008. Attached is the revised version.

This document was revised in 2006; the revised version is attached.

Revised January 11, 2005. This is the revised version.

This form was revised in 2006.  The revised version is attached.

This procedural memo was updated on August 4, 2008. Attached is the updated memo. DES will use MMIS information to obtain address information for EAEDC and TAFDC clients and to clarify whether a case has been closed by DTA for administrative reasons during DES processing of the case, and  to clarify whether a client has been approved for SSI. DES determinations should continue if DTA cases close for failure to meet work requirement or because of time limit.

This issuance is no longer in effect. See Procedural Standards PS 04-1, 04-2, and 04-3 for current language regarding similar issues.

This Procedural Standard describes the SSI Revisions to criteria effective February 19, 2002, that were announced in the May, 2002 edition of Social Security eNews..

This Procedural Standard provides an overview of SSI and Department of Transitional Assistance regulations regarding the evaluation of disability on the basis of mental disorders.

For the purposes of this policy Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

For the purposes of this policy Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

For the purposes of this policy the Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

The purpose of h s guideline is to insure the proper and timely release of medical recordscontaining protected health information (PHI) requested by clients, legal representatives andor eligibility representatives. This guideline should also insure properdocumentation of additional correspondence and exchange of information regarding cases. Additionally, this documentation will cover guidelines for documenting and responding to subpoenas. Page 5)

The purpose of this guideline is to insure the proper and timely release of medical records containing protected health information (PHI) requested by third parties. This guideline shouldalso insure proper documentation of additional correspondence and exchange of information regarding cases. Additionally, this documentation will cover guidelines for documenting and responding to subpoenas. (page 6)

DES procedural memo to its staff regarding how to determine when pregnant women meet the disability standards for EAEDC and TAFDC.

Explains DES' procedures for handling DTA-originated cases where the available information is insufficient to determine that the individual meets SSI disability standards.

This memorandum summarizes the situations when reopening of a prior determination is appropriate and describes the procedures to follow in reopening and closing the case.

DES must review all prior DES disability files of a recipient when making determinations on new claims. Memo provides procedures for doing this.

Treating source medical opinions are given controlling weight in the disability determination process unless they are not well-supported by objective clinical evidence or are in conflict or inconsistent with other medical and/or non medical evidence in the file. Such situations require a careful analysis of all available information and may involve numerous considerations including the quality, consistency and detail of the evidence provided as well as the specialty and expertise of the other medical sources. The file must contain a written explanation of the resolution of conflicting information as well as the reasoning for assigning weight to treating source or other medical opinions.