441—90.4 (249A) Application. The provider shall process an application for targeted case management no later than 30 days after receipt of the application. The provider shall refer the applicant to the department’s service unit if other services are needed or requested.
	 90.4(1) Application process and documentation. The application shall include the member's name, the nature of the request for services, and a summary of any evaluation activities completed. The provider shall inform the applicant in writing of the applicant's right to choose the provider of case management services and, at the applicant’s request, shall provide a list of other case management agencies from which the applicant may choose. The provider shall maintain this documentation for at least five years.
	 90.4(2) Application decision. The provider shall inform the applicant or the applicant’s legally authorized representative of any decision to approve, deny, or delay the service in accordance with notification requirements at 441—subrule 7.7(1).
	 90.4(3) Delayed services. The application shall be approved and the member put on the referral list for assignment to a case manager when targeted case management cannot begin immediately because there is no opening on a caseload. The provider shall notify the applicant or the applicant’s legally authorized representative in writing of approval and placement on the referral list. If an applicant is on a referral list for more than 90 days from the date of application, this shall be considered a denial of service.
	 90.4(4) Denying applications. The provider shall deny applications for service when:
	  a.   	 The applicant is not currently eligible for Medicaid; or
	  b.   	 The applicant does not meet the eligibility criteria in rule 441—90.2(249A); or
	  c.   	 The applicant or the applicant’s legally authorized representative withdraws the application; or
	  d.   	 The applicant does not provide information required to process the application; or
	  e.   	 The applicant is receiving targeted case management from another Medicaid provider; or
	  f.   	 The applicant does not have a need for targeted case management.
[ARC 7957B, IAB 7/15/09, effective 7/1/09]