Adult Medicaid Manual MA-2340 CHANGE IN SITUATION

01/01/95

I. GENERAL INSTRUCTIONS APPLICABLE TO ANY CHANGE IN SITUATION

A. Any change in the budget unit's situation must be reviewed promptly when the county department of social services learns of a change from any source.

NOTE: The budget unit consists of individuals who apply for assistance and those who have financial responsibility for him. Refer MA-2260

B. When the county has information about anticipated changes in circumstances which may affect eligibility, it must reevaluate continued eligibility at the appropriate time based on those changes.

C. Appropriate action must be completed within 30 calendar days after the county department of social services learns of the change.

D. When a change in situation is reported, ask if other changes have occurred. Be alert to any change that affects more than one eligibility requirement.

E. Retain the six months certification period, except when a change in financial responsibility requires one certification period to be shortened to match the other.

F. When an active Medicaid applicant/recipient begins to receive SSI, the deductible must be recomputed based on the number of months in the c.p. prior to SSI Medicaid authorization. See example 5 in II.E.12., below.

G. Divide a 12 months certification period into two six months periods and apply the change in the six months period in which it occurs. If no deductible results, retain the 12 months certification period.

H. The recipient's delay in reporting a change may require that income for several months be applied to a deductible for as few as one or two months.

I. When more than one change in situation is reported, implement all changes with the same effective date at the same time. When there are different effective dates, implement each separately in the order in which they occurred.

J. Enter or attach all verifications, including notations of telephone contacts, to the verification/redetermination form.

K. Enter changes in EIS according to the EIS Manual.

L. Send the recipient/representatives/facility notice of any change in certification/authorization/deductible/patient's monthly liability, etc., according to MA-2420.