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.

Certain EAEDC elderly recipients (age 65 or older) may now be eligible and must reapply for SSI benefits because of a change in their noncitizen status or more up-to-date information on their work history. They were initially denied SSI because of their noncitizen status. Some of these recipients may also be disabled with a disability expected to last 12 months or more. In addition to reducing Department costs, encouraging applicants/recipients to apply for and follow through with the SSI process ensures a greater cash benefit for the recipient once the SSI is approved.

Obsoleted by FOM 2004-10.

Field Operations Memo 2004-7 and Field Operations Memo 2004-8 told TAO Staff that budget shortfalls left the Department without sufficient EAEDC funding for the remainder of fiscal year 2004. This deficiency required the elimination of Participating in the Massachusetts Rehabilitation Commission (MRC) Program as a categorical eligibility reason for EAEDC and revised the EAEDC medical standards to conform to the SSI disability criteria (excluding the durational requirement).

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.

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.

TAFDC and Food Stamp benefits for eligible adult with child who is ineligible alien; TAFDc caretaker exemption not dependent on relationship; EAEDC-- doctor signing Medical Report does not have to be Mass Health provider.

AFDC: Must use current school year calendar to determine if 18 year-old is expected to graduate by 19th birthday; FS: treatment of situation where person works off their rent; EAEDC: case must be opened if eligible while awaiting response from agency reviewing medical report.

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.