All Medicaid Programs |
Obsolete Policy |
The UPP recipient or representative is responsible to report a change in any circumstance which may affect eligibility for UPP within 10 days of the date of the change. Changes in household composition and health insurance availability are among the changes that must be reported.
If the 10th day is a non-business day, give the client until the first business day following the 10th day.
A report of a change or other information may be received from a source other than the recipient.
See Section 1009-1 for a description of changes that must be reported.
In some circumstances reported changes must be evaluated to determine if they could affect eligibility during the 12 month certification period.
Only act on the information when the enrollee requests a Medicaid determination or the reported change is an exception to the 12 month certification period. (See Section 1008)
Use the computer matches and collateral contacts whenever possible to verify items of eligibility.
Do not request hard copy verification of items that are not needed for eligibility or that have previously been verified and are not subject to change.
The eligibility agency may accept client attestation for all change reports except for claims of citizenship and immigration status (731)
The agency must promptly determine if the information provided by the client is reasonably compatible with the available electronic data match. (751)
If continued eligibility cannot be determined by electronic data match, the agency must request the necessary verification from the client.
Workers must request any necessary verification within 10 days of the date a change is reported or information is received.
Workers must request only verification needed to determine current eligibility.
Give clients at least 10 days from the date you mail the written request to provide verification. If the 10th day is a non-business day, give the client until the business day following the 10th day to provide verifications.
If the client does not return all requested verification by the verification due date, the eligibility agency ends benefits for the first month it can give advance10-day notice.
The client must re-apply during the next UPP open enrollment.
If the client provides all requested verification by the verification due date, or by the end of the report month, whichever is later, the agency continues with the eligibility determination.
For an adverse action, make the change for the first month that the eligibility agency can give 10-day notice.
If the action is in the client’s favor, or there is no change in benefits, make the change for the month immediately following the change report month.
If the eligibility agency receives all of the verification after the effective closure date, and before the end of the month immediately following the closure, it is a new application.
A new application form is not required.
Waive the enrolled in insurance rule.
Open enrollment is waived for the month immediately following closure.
All factors of eligibility must be met.
The agency may begin a new 12-month certification period if it has verified all eligibility criteria after a client change report.
The electronic client information will be transferred to the FFM when UPP is closed.
Mail returned by the post office with no forwarding address indicates a change. See Section 811-4 to decide what steps to take.
When a household reports a change of address, provide the household with voter registration information. (See Section 109).