[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-203436-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-203436-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","1717-the-applicationredetermination-process-application-process-and-redetermination-process","17.17 THE APPLICATION/REDETERMINATION PROCESS - Application Process and Redetermination Process","","The document details the application and annual redetermination process for ADW, stating it generally follows SSI-Related Medicaid procedures with specific exceptions. It outlines worker responsibilities for accepting and processing two DHS-2 FRM forms (yellow and white), including expiration checks, fax routing to the ADW Utilization Management Contractor or originating agencies, and steps for financial eligibility determination. It also specifies application timing rules, face-to-face scheduling deadlines, waiver-slot pending guidance, asset assessment, and annual medical-necessity verification requirements.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/1717-the-applicationredetermination-process-application-process-and-redetermination-process/203436/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/1717-the-applicationredetermination-process-application-process-and-redetermination-process/203436.png","ImageObject",300,407,{"name":42,"@type":43},"McQueen","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-03","2026-09-04",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How does the ADW application/redetermination process differ from SSI-Related Medicaid?","Question",{"text":63,"@type":64},"It generally matches SSI-Related Medicaid procedures but includes specific exceptions, especially around worker responsibilities and the handling of DHS-2 FRM forms for ADW.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What are the differences between the yellow and white DHS-2 FRM forms?",{"text":68,"@type":64},"The yellow form is used to determine medical necessity for an ADW slot and includes expiration handling with fax routing to the ADW Utilization Management Contractor. The white form confirms medical eligibility and slot availability for ADW and is faxed back to the originating agency after worker expiration and financial checks.",{"name":70,"@type":61,"acceptedAnswer":71},"What happens during ADW redetermination and what is required annually?",{"text":72,"@type":64},"Redetermination is completed once a year without a face-to-face interview. Medical necessity must be verified annually using a letter or document from the UMC, after which the same criteria and procedures used for applications apply.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},203436,1788560795,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":80,"read_time":123},5909890329169,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","17.17 THE APPLICATION/REDETERMINATION PROCESS  \nA. APPLICATION PROCESS  \nThe application/redetermination process is the same as for SSI-Related Medicaid found in Chapter 1, with the following exceptions:  \nThe Worker is responsible for the following:  \n1. Accepting form DHS-2 . FRM  \nThere are two versions. The yellow form instructs the worker to determine financial eligibility. The white form allows the worker to confirm medical eligibility for an ADW slot. The yellow form will originate from the ADW Utilization Management Contractor (UMC) . The white form will originate from Case Management agency or the Bureau of Senior Services.  \na. The yellow DHS-2 . FRM requests medical necessity for a slot.  \n• The yellow DHS-2 . FRM has an expiration date. If the form is expired, the Worker needs to check the box stating it is expired and fax the form to the ADW Utilization Management Contractor (UMC) .  \n• If the yellow DHS-2 . FRM is not expired, the Worker completes the financial determination. If the client is financially eligible the worker checks the box noting they are eligible and faxes the form to the UMC. The Worker confirms the pending ADW category if financial eligibility has been determined. The client is then pended up to 90 days by the data system and notified by a RAPIDS system generated letter.  \n• If ineligible for ADW, the Worker then checks the box on the yellow DHS-2 . FRM stating the client is ineligible and faxes the form to the UMC. The Worker then continues evaluation for all other DFA programs. Medical eligibility for the ADW will not continue and the UMC closes the case. The client will be sent a denial letter by the data system.  \nb. The white DHS-2 . FRM confirms the client is medically eligible and that a slot is available for the ADW program.  \n• Worker checks the expiration date on the white DHS-2 . FRM. If the form is expired, the Worker needs to check the box stating it is expired and fax the form to the originating agency.  \n• The Worker completes or updates financial eligibility.  \n• If the white DHS-2 . FRM is not expired, the Worker checks the appropriate box noting eligible or ineligible and faxes the form back to the originating agency.  \n• If there is no expiration date on the white DHS-2 FRM, it should be returned to the originating agency, noting there is no expiration date.  \nNOTE: When the applicant’s eligibility for, or enrollment in, this program is pending, due to the lack of a waiver slot or other reason, he must not be refused the right to apply due to his pending status for the ADW group, but must be evaluated for any or all DFA programs.  \nEXAMPLE: John Bumgardner applies for ADW which requires a medical eligibility decision by the ADW Program and a financial determination by an Income Maintenance Worker. While his medical eligibility decision ispending, he visits his local DHHR Office and applies for SNAP. Although his medical eligibility for ADW has not been determined and a financial determination cannot be made by the Worker for ADW, his pending status for this program does not prevent his evaluation for all other Medicaid groups or DFA programs for which he may qualify.  \n2. Processing the application as for any other Medicaid AG, presuming that medical eligibility has been determined. The date of application is the date that the client or his representative contacts the local office by phone, fax, mail, e-mail or in person to inquire about making an application.  \nNOTE: The applicant has only 60 days after acquiring a slot to establish financial eligibility and be enrolled in the waiver program, or they will lose their slot. Timely financial eligibility determinations are critical. The Regional Program Managers will be notified by Bureau for Medical Services (BMS) of medically-eligible clients who will then notify the applicable Community Service Managers (CMS) . The CSM will distribute the list to field supervisors of those that have been allotted an available slot.  \nIf a fac","cbCaia6caG3i71mV","https://ap.wps.com/l/cbCaia6caG3i71mV","pdf",62024,"English","# 17.17 THE APPLICATION/REDETERMINATION PROCESS\n## A. APPLICATION PROCESS\n## B. REDETERMINATION PROCESS","[{\"question\":\"How does the ADW application/redetermination process differ from SSI-Related Medicaid?\",\"answer\":\"It generally matches SSI-Related Medicaid procedures but includes specific exceptions, especially around worker responsibilities and the handling of DHS-2 FRM forms for ADW.\"},{\"question\":\"What are the differences between the yellow and white DHS-2 FRM forms?\",\"answer\":\"The yellow form is used to determine medical necessity for an ADW slot and includes expiration handling with fax routing to the ADW Utilization Management Contractor. The white form confirms medical eligibility and slot availability for ADW and is faxed back to the originating agency after worker expiration and financial checks.\"},{\"question\":\"What happens during ADW redetermination and what is required annually?\",\"answer\":\"Redetermination is completed once a year without a face-to-face interview. Medical necessity must be verified annually using a letter or document from the UMC, after which the same criteria and procedures used for applications apply.\"}]","17.17 THE APPLICATION/REDETERMINATION PROCESS - Application Process and Redetermination Process | PDF"]