TMPPM 2008 > Provider Information > Client Eligibility > Medically Needy Program (MNP)

4.5.3 Medically Needy Program for CSHCN Services Program Clients

The CSHCN Services Program requires client participation in MNP. Clients are given 60 days of provisional CSHCN eligibility, and referred to the Medicaid/MNP. Clients must provide CSHCN with a Medicaid and MNP determination of eligibility before the end of the 60-day provisional eligibility period. When clients send CSHCN a copy of the written Medicaid/MNP determination before the end of the 60 days, CSHCN pays for all covered medical services provided during the 60 days if the client is not eligible for Medicaid.

If a client sends the Medicaid/MNP determination after the 60-day period, CSHCN eligibility begins on the date CSHCN receives the determination. CSHCN only pays for prescription drugs (not over-the-counter), meals, lodging, transportation, expendable medical supplies, nutritional supplements, glucose monitors, transportation of remains, and total parenteral nutrition (TPN) during the provisional eligibility period. An additional 30 days of provisional eligibility may be granted under unusual circumstances.

Additionally, CSHCN may ask clients to apply to the Medicaid/MNP when $2,000 or more in medical bills has been paid or is expected to be paid by CSHCN. Clients are given 60 days to apply to the Medicaid/MNP and send the determination to CSHCN. A client's CSHCN eligibility is terminated if he or she does not comply with the request to apply to Medicaid/MNP. CSHCN clients receive no limitations on benefits during this period for their program-covered diagnosis or services. For more information, call the CSHCN MNP at 1-800-252-8023.

Refer to: "Medically Needy Claims Filing" .