Medicaid Policy                                                                 

1007-2 Effective Date of Changes That Cause UPP Payment to Decrease

Effective Date: September 1, 2015

Previous Policy

If a change is reported and there is sufficient information to make the change, do not wait for verification to decrease the payment.  

Decrease the payment in the first month in which the agency can give proper notice and send a request for verifications allowing 10 days from the date of the notice to provide verifications.

If the member does not return all requested verification by the verification due date, the eligibility agency ends benefits in the first month it can give 10-day advance notice. (See Section 811)

If the member did not report a required change within 10 days, the payment decrease is effective the month following the date the eligibility agency learns of the change.  Allow for change processing standards and evaluate the overpayment back to the effective date of the change.

See Section 1009 for more information about reported changes.