Make input to suspend Medicaid eligibility.
Complete the BHLT screen. Enter “A” in question 2-M (Agree to Assign Rights to Payments
for Medical Support and Medical Care to the State Medicaid Agency) of the BHLT screen
(See MSOM INTRANETSSI 019.020).
Suspend Medicaid eligibility by using an SSA-450-SI, input the following:
Prior Error (PR) Field — Input PR9 (See SM 01015.002D. - Description of PR Field).
Third Party Insurance (PT) Field — Input “F” and the four position date (MMYY) of
the month after the month the child left the United States (e.g., PTF0990) (See SM 01005.350C. - Description of PT Field).