GIS 10 MA/022: LDSS-2831A "Temporary Medicaid Authorization"

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director, Division of Coverage and Enrollment

Subject: LDSS-2831A "Temporary Medicaid Authorization""

Effective Date: Immediately

Contact Person: Local District Support Unit, Upstate (518)474-8887, NYC (212)417-4500

This General Information System (GIS) message is being issued as a reminder that the LDSS-2831A "Temporary Medicaid Authorization" is only to be given to individuals who are determined Medicaid eligible and need to receive Medicaid covered care, services and/or supplies prior to receipt of a permanent Common Benefit Identification Card (CBIC). This includes individuals who are also applying for Temporary Assistance (TA). The LDSS-2831A is issued to a Medicaid eligible recipient pending his/her receipt of a CBIC. The LDSS-2831A is intended for use between the time of the determination and the actual delivery of the permanent card, and is valid only for a specific number of days, up to 15 days maximum.

When issued, the Temporary Medicaid Authorization is a guarantee of payment to any enrolled Medicaid provider and must be supported with fee-for-service coverage on WMS. Therefore a Temporary Medicaid Authorization should not be provided before a full determination is made. Once issued, the local district must authorize Medicaid coverage for the time period indicated on the LDSS-2831A, even if issued in error. Family Health Plus individuals are not to be given a LDSS-2831A.

Please share this reminder with your TA eligibility staff as this applies to Medicaid issued on a TA case.