Article 8 Section 01 Certification Table of Contents TITLE PG CITE General 080101A Beginning Month 080101B Ending Month 080101C Automatic Extension Process 080101D CMSPG LTR 08 0112 080101 Certification 080101A This section contains guidelines for determining certification periods General for CMS applications processed via a County worker at a CMS eligibility site or by an HOS worker for patients admitted to the hospital through the emergency room 080101B The applicant must meet all eligibility criteria before certification The Beginning first month of the certification period depends upon when the applicant Month has met all eligibility criteria If all criteria are Then the certification period begins met for the application month that month not met until the following month the month following the application month Note In the case of erroneous certification refer to 0802 Examples First Month of the Certification Period Scenario 1 The applicant is admitted to the hospital on July 28 and discharged on August 5 His net nonexempt income for July exceeds the CMS income limit and his estimated net nonexempt income for August is below the CMS income limit The beginning month of the certification period is August Scenario 2 The applicant is admitted to the hospital on June 15 and discharged on June 20 In June her net nonexempt property exceeds the CMS property limit She has thirty days from the denial notice of action to spend the excess property down to within the limit On July 10 she provides proof that she spent the property appropriately The beginning month of the certification period is June Scenario 3 The applicant received treatment at a Primary Care Clinic or Hospital Emergency Room on June 15 He had no current CMS eligibility at the time the treatment was provided but is now requesting CMS coverage for that uncertified visit If within 30 days from the date of the uncertified visit the applicant contacts the ASO to schedule the CMS intake interview and if all other eligibility factors are met the beginning month of the certification period is June If the phone call was made more than 30 days from the date of the uncertified visit or if patient does not meet all other eligibility factors for the month of the uncertified visit the beginning month of eligibility is the month of July Refer to 0201 for additional information 080101C Ending Month The standard certification period for applicants is for up to six months When a foreseeable change in circumstances that affects eligibility is expected during the certification period the certification period may be less than six months The last month of the certification period is the last month when all eligibility criteria are met When the certification period is less than six months the worker must state the reason in the case record comments and on the NOA that certifies CMS Examples Certification Period Ending Month Scenario 1 The applicants net nonexempt income is below the income limit in the month of application but its expected to exceed the income limit the following month The certification period is one month Scenario 2 The applicants INS document expires in three months The certification period is three months Scenario 3 The applicant needs to see a doctor or fill a prescription within 72 hours and is unable to get a bank statement The worker can call the bank to verify the account balance and certify one month Upon receipt of the bank statement the worker may extend the certification period Scenario 4 The applicant applies in the month of May and is receiving biweekly gross earned income of 595 Based on the paydays the applicant will receive two paychecks per month for the period of May through August and will get a third paycheck in September The gross income totals 128936 when converted to a monthly amount using the 2167 factor The net nonexempt income is 119936 after deducting the 90 standard work expense which puts the applicant over the CMS MNL The worker will recompute eligibility using the actual income of 595 x 2 paydays in the month This equals a net countable income of 1100 after deducting the 90 The worker will certify for the months of May through August MPG Letter 699 209 080101D Individuals who have been certified CMS with the standard certification Automatic Extension The ASO shall send a list of beneficiaries who have been identified as CMSPG LTR 08 0112