0910.050.10.05  REINSTATEMENT OF INDIVIDUALS SUSPENDED ON TMA

Upon receipt of the quarterly report suspended TMA individuals must be reinstated.

If “good cause” is allowed (Section 0910.025.10) reinstate back to the date of the suspension.  If “good cause” is NOT allowed reinstate effective the first of the month following the receipt of the report.

To do this, make the following entries:

Field 5

Case Action 35

Field 38a

Enter the appropriate quarterly report code

Field 33, 34, 35

100% budget required if a “4” is entered in field 38a

For suspended individuals, make the following entries:

Field 13e

Enter appropriate date

Field 13g

Enter level of care “T”

Field 13g2

Enter “T” for no sanction

This reinstated should be done as quickly as possible to prevent any disruption in health coverage or managed care enrollments.  If TMA eligibility is restored from suspended status, send a quarterly report if the third quarterly report is needed.