405 IAC 2-1-2 - Interview of applicants and members

Authority: IC 12-13-5-3; IC 12-13-7-3; IC 12-15-1-10

Affected: IC 12-15-4; IC 12-15-5

Sec. 2.

(a) In addition to the requirements of 470 IAC 2.1-1-2, each applicant and member, or an individual authorized to act on their behalf, must be interviewed by the office at the time of the initial investigation and at each annual reinvestigation of eligibility.

(b) The initial investigation interview required under subsection (a) may be conducted:

(1) in a division or county office;

(2) at a home visit;

(3) by telephone; or

(4) at a community location designated by the division or the division's designee.

(c) The annual reinvestigation interview required under subsection (a) may be conducted:

(1) in a division office;

(2) at a home visit;

(3) by telephone;

(4) by mail; or

(5) at a community location designated by the division or the division's designee.

(d) Applications for Medicaid are filed on the form prescribed by the division.

(e) An applicant or a member may use an authorized representative to apply for Medicaid, represent the applicant or member in interviews, and notify the division of any changes. The authorization must be submitted under 42 CFR 435.907(a), except as provided in subsections (g) and (h).

(f) Notwithstanding the availability of an authorized representative, the division may require personal contact with an applicant or a member to gather information necessary for determining eligibility.

(g) The parents of an applicant or a member less than eighteen (18) years of age may apply for Medicaid on behalf of the applicant or member without the written authorization specified in subsection (e).

(h) The written authorization specified in subsection (e) is not required if medical documentation signed by a licensed physician shows that an applicant or a member is medically unable to provide an authorization. This subsection does not apply if the applicant or member is deceased at the time the application is being made.

(i) Unless there is a legally authorized agent, such as an authorized representative, employees of nursing facilities may not be interviewed on behalf of a resident in their facility unless certified medical documentation shows the applicant or member is medically incapable of being interviewed and there is no one else to act on the applicant or member's behalf. This subsection does not apply if the applicant or member is deceased.

(j) If a member dies before an interview for Medicaid benefits and there is not a valid authorized representative on file with the family and social services administration, only a personal representative as defined under 45 CFR 164.502(g)(4) may complete the interview.

(k) For an applicant or a member of long term care services, an application for assistance, including recertification of eligibility for assistance, must disclose a description of any interest the individual or community spouse has in an annuity, or similar financial instrument as specified by the Secretary of Health and Human Services, regardless of whether the annuity is irrevocable or is treated as an asset, as follows:

(1) The application or recertification packet includes a statement signed by the individual that the state will become a remainder beneficiary under the annuity or similar financial instrument because of providing Medicaid.

(2) On disclosure by an applicant or a member under this subsection, the state will notify the issuer of the annuity of its right as a preferred remainder beneficiary for Medicaid furnished to the individual.

(l) The division shall accept an application for Medicaid signed with an electronic signature.

(m) An applicant or a member not meeting the requirements of this section is ineligible for Medicaid.

(n) The formal initial investigation interview required under subsection (a) is not required for individuals subject to the modified adjusted gross income methodology set forth under 42 CFR 435.603.

Notes

405 IAC 2-1-2

Office of the Secretary of Family and Social Services; 405 IAC 2-1-2; filed Mar 1, 1984, 2:31 p.m.: 7 IR 1013, eff Apr 1, 1984; filed Jun 19, 1984, 10:25 a.m.: 7 IR 1821, eff Jul 1, 1984 [IC 4-22-2-5 suspends the effectiveness of a rule document for thirty (30) days after filing with the secretary of state. LSA Document #84-29 was filed with the secretary of state June 19, 1984.]; filed Feb 16, 1993, 5:00 p.m.: 16 IR 1781; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; filed Feb 19, 2009, 10:53 a.m.: 20090318-IR-405080195FRA; filed Aug 18, 2009, 11:33 a.m.: 20090916-IR-405080325FRA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Apr 8, 2014, 12:37 p.m.: 20140507-IR-405130533FRA Readopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFA Filed 6/11/2021, 2:35 p.m.: 20210707-IR-405190602FRA Filed 6/26/2024, 10:03 a.m.: 20240724-IR-405230819FRA

Transferred from the Division of Family and Children (470 IAC 9.1-1-2) to the Office of the Secretary of Family and Social Services (405 IAC 2-1-2) by P.L.9-1991, SECTION 131, effective January 1, 1992.