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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

79 and other necessary action consistent with the provisions of Title VI of the 1963 Civil Rights Act, as amended 42 U.S.C. §2000e et seq. and section 504 of the Rehabilitation Act of 1973, as amended 29 U.S.C. §791. 8.100.3.P. Redetermination of Eligibility 1. “Redetermination of eligibility” is a case review and/or the request for necessary verification to determine whether a member enrolled in a Medical Assistance Program continues to be eligible. Eligibility shall be redetermined at least every twelve months since a member’s last eligibility determination. Eligibility may be redetermined through telephone, mail, or online electronic means. Prior to making a determination of ineligibility, the eligibility site must review on all bases of Medical Assistance eligibility for a member. 2. “Ex Parte Review” is a redetermination of eligibility for a member without requesting verification by utilizing available information from the member’s account, electronic sources, and other assistance programs. Ex parte Reviews will be conducted as follows: a. If verified information is available for any of the six months prior to the redetermination month, and the member meets all other eligibility requirements, then an approval notice will be sent to eligible members of the household who are requesting assistance. This approval notice shall include directions on how to view the information used to determine eligibility and the member is not required to sign and return such notice if all information provided on such notice is accurate. b. If all required information is not available and/or the information on file does not support a finding of eligibility, a redetermination form, as described in Section 8.100.3.P.3, and/or a verification form will be issued to the household at least 30 days before the end of the eligibility period.