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MEDICAL SERVICES POLICY MANUAL,SECTION I

I 630 ARChoices Waiver

• TEFRA • Autism • SSI Related Groups • Pregnant Women

I-630 ARChoices Waiver MS Manual 06/01/25 Recipients will be advised to report any changes in the amount of household income or resources. If at any time the Division of Aging, Adult and Behavioral Health Services (DAABHS) or Division of Provider Services and Quality Assurance (DPSQA) Office of Long Term Care (OLTC) determines that cost effectiveness is not met, that the client no longer meets the requirements for Intermediate Level of Care, or that the client is no longer receiving Waiver services, the Waiver case will be closed. If the Waiver case is closed for any reason, the system will determine if the client is eligible for any other Health Care category. If eligible in another category, the recipient can be certified in that category without requiring a new application. If the ARChoices Waiver client loses eligibility for one (1) month only, the case may remain open with an overpayment submitted for the month of ineligibility. When the County has advance knowledge of ineligibility in a future month (For example: land rent paid annually), procedures at MS E-410 will be followed, advance notice given, and the case adjusted. If the Waiver client will be ineligible for more than one (1) month, the case will be closed and a new application will be required. A Waiver client may appeal an adverse decision made on their case as outlined in MS L 100-173. If a timely appeal is received on or before the date listed on the Notice of the Action, the petitioner’s case will remain open and benefits will continue until the hearing decision. If the petitioner wishes not to continue benefits until the hearing decision, they must opt out.