Date: May 8, 2020
To: Long Term Care Facilities - Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Supportive Living Program (SLP), Medically Complex for the Developmentally Disabled Facilities (MD/DD) and Specialized Mental Health Rehabilitation Facilities (SMHRF)
Re: New Transaction Audit Number (TAN) Status Code 17
This notice informs Long Term Care (LTC) providers of a new Transaction Audit Number (TAN) status code “17”. This status code is being implemented in conjunction with the new LTC admission processing policies that were detailed in the February 27, 2020 provider notice entitled Implementation of New Policy for Long Term Care Admission Processing.
Effective in March 2020, Healthcare and Family Services (HFS) began processing pending admission TANs for individuals with active community Medicaid and updating the TAN status code to a “17”. The REF field displayed on the MEDI LTC Inquiry results will display “HFS3654”. This is to alert the LTC provider and the Department of Human Services (DHS) caseworker that the form HFS 3654 “Additional Financial Information for Long Term Care Applicants” may still be needed.
If a DHS caseworker determines the form HFS 3654 is needed and has not yet been received, a verification checklist (VCL) will be sent requesting the form 3654. If the form 3654 is not returned by the due date indicated, the LTC services will be terminated. The DHS caseworker review will also include updating admission or discharge dates and patient credit amounts if the existing information is incorrect. Once the DHS caseworker reviews the TAN, the status code could be updated to a 13, 12, 02 or 01. There is not a specific timeline for the DHS caseworker review to occur.
The form HFS 3654 should be submitted to the appropriate DHS office via fax, mail or through the Application for Benefits Eligibility with the ABE application, Manage My Case (MMC), or the ABE Partner Portal.
NOTE: Currently HFS is the primary agency responsible for the assignment of TAN status code “17”. However, both HFS and DHS will complete admissions using this new status code in the upcoming months.
Questions regarding this notice may be directed to the Bureau of Long Term Care at 1-844-528-8444.
Interim Medicaid Director