Page 450

MEDICAL SERVICES POLICY MANUAL,SECTION O

O 920 Medically Needy Case Actions Exceptional and Spend Down The caseworker will: 1. For AABD-EC cases, review the statements on the DCO-95. 2. Recompute income eligibility. 3. If additional information/verification is needed to establish continuing eligibility, the recipient will be given a DCO-700, Notice of Action, which will list the information that needs to be returned and the date it should be returned.

If the recipient fails to provide any information necessary to redetermine continued eligibility as requested, the caseworker will close the case at the end of the specified time. If the recipient requests additional time to provide the information, the caseworker will send a second DCO-700 that clearly states what information is needed by the end of the extended time period. “Failure to provide” by the end of the extended period will result in case closure.

O-920 Medically Needy Case Actions - Exceptional and Spend Down MS Manual 01/01/14 Changes in Exceptional Medically Needy Cases may be made in ANSWER prior to reevaluation or between scheduled reevaluations. Changes in Spend Down cases can only be effected if they are completed before the expiration of the Spend Down entitlement period. Such changes can include the dropping or adding of a family member (for example, a newborn child) or a change in address.

O-930 Change Notification to Medically Needy Recipient by County Office MS Manual 01/01/14 The ten day advance notice requirement applies to all categories of Medically Needy and is given in all instances of adverse action with the following exceptions. Advance notice is not required when: 1. The agency has factual information confirming the death of the recipient. 2. The agency receives a written statement signed by a recipient that he or she no longer wishes assistance, or that gives information which requires termination or reduction of assistance, and the recipient has indicated that he understands the consequences of supplying such information. 3. The recipient has been admitted or committed to an institution thereby making him ineligible except when special conditions are met. (Re. MS J-130). 4. The recipient’s location is unknown and agency mail directed to him has been returned by the Post Office indicating no known forwarding address. The recipient’s Medicaid card must be made available to him if his whereabouts becomes known during the eligibility period covered by the returned ID card.