All Medicaid Programs |
Obsolete Policy |
Special Notice: Effective March 18, 2020 until the end of the Health Emergency due to COVID-19, refer to the Q&As in this manual for special instructions about certification periods. During the emergency period, eligibility cannot be terminated except for a few exceptions noted in the Q&A document being added to the manual.
Reviews are required for all Medicaid programs. A review is used to determine an individual’s eligibility for the next certification period.
Complete the review based on whether or not a member is required to participate in the review process (See 721-1).
Signatures are required on reviews that require member participation.
End eligibility for individuals who fail to complete a review, when member participation is required, effective the end of the month in which the agency can send proper notice.
A new certification period can be set for other medical programs with future review dates if all factors of eligibility have been reviewed, with the following exceptions.
A time limited program which is set to end before the next review (721-4);
An Adult Expansion or Targeted Adult Medicaid program; or
Situations where an ex parte review cannot be completed because member participation is required (721-1).
See 715 for length of certification period.
See 435 for budgeting of income.
See 815 for changes during the certification period.