The following procedures deal with new PACE certifications:

Enrollments must be processed by the last day of the month so that PACE services can begin on the 1^st of the following month.

1. OHCA will notify worker of medical approval.
2. PACE will provide written notification of enrollment for case file.
3. In IMS, type MDL and then type MDI next to line to verify current authorization date. If there is no MDL line, contact Avis Hill at Oklahoma Health Care Authority.
4. Client will be M/A on HH tab. (added to other benefits if entitled)
5. Certify case effective the date of enrollment with original application date. Use reason code (17); attained technical eligibility. Resend application date. Resend notice indicator. Date of redetermination is certification date. (Sync with SNAP if issuing)
6. Choose appropriate categorical relationship for PACE. (Note: FACS will have “Medicaid” in the dropdown, but the intent is MEDICARE Part B).
   1. PMA: Pace Medicare Aged
   2. PMB: PACE Medicare Blind
   3. PMD: PACE Medicare Disabled
   4. PNA: PACE Non-Medicare Aged
   5. PNB: PACE Non-Medicare Blind
   6. PND: PACE Non-Medicare Disabled

7. On Medical Financial tab, resend Medical Application Reason (Advantage Waiver), Medical Application Source (County Office) & Spend-down Computation Period (01).
8. Save case. CHECK GD screen for accuracy. Make changes if needed.
9. Save case and clear on worker authority. CHECK ED screen for accuracy.
10. Check NL screen for appropriate notice generated. Have any SNAP change notices deleted by Remedy to avoid confusion on the part of the client.
11. Send a Remedy ticket. Problem Area: Long Term Medicaid. Problem: PACE. In body of ticket “PACE certification: push to iCE effective (enrollment date)”.
12. Contact Lisa Gallaway & Avis Hill that the ticket has been submitted.
13. Worker will be notified when ticket is completed.