Department of Health
Office of Temporary and Disability Assistance
Medicaid Eligibility Under TANF Assistance Eligibility for Medicaid and public assistance programs is determined by local social services districts, which are overseen by the Office of Temporary and Disability Assistance. Individuals who are ineligible for public assistance funded by the Temporary Assistance for Needy Families (TANF) program may be eligible for Medicaid. Therefore, when an individual is denied, or loses, TANF benefits, the individualís eligibility for Medicaid must be determined in a separate review. We selected nine social services districts and examined whether this separate review of Medicaid eligibility was conducted when required. We identified a number of instances in which the review was not conducted, and in some of these instances, it was determined by the districts (at our request) that the individuals would have been found to be eligible for Medicaid if the review had been done.
For example, in one district, in 13 of the 50 cases that we reviewed, the applicantís eligibility for Medicaid was not separately reviewed when the applicant was denied TANF benefits. These 13 cases affected a total of 44 individuals, and on the basis of the documentation in the files, the district was able to subsequently evaluate the Medicaid eligibility of 17 of the 44 individuals, determining that 16 of the 17 individuals would have been eligible for Medicaid when their TANF benefits were denied if their eligibility had been reviewed at that time. We recommended that the Office of Temporary and Disability Assistance and the Department of Health work with the local districts to ensure that Medicaid eligibility is reviewed when required.
For a complete copy of Report 2000-S-22 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.