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TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 26 Children who have been determined eligible based on self-attested information are entitled to the 12-month continuous eligibility period. Coverage may not be terminated for such children during a continuously eligible period if, in conducting post-enrollment verification, the state obtains information that indicates that the child does not meet all the eligibility requirements unless the information indicates that one of the limited exceptions to continuous eligibility above applies. If the self-attested information indicates that the child is eligible, the state is not considered to have made an erroneous determination, even if there is an inconsistency between the attested information and information subsequently obtained from family or electronic data sources after enrollment. The receipt of information is considered a change in circumstance. See Section 14800 Verifications of Factors of Eligibility. Children whose citizenship or satisfactory immigration status is not verified have not been determined eligible. Continuous Eligibility does not apply to children who are receiving benefits under a reasonable opportunity to provide (ROP) period if the child's status cannot be verified. See Section 14390.1 Reasonable Opportunity to Provide Documentation of Citizenship and Identity or Alien Status. 27 DE Reg. 680 (03/01/24) 14820 Changes in Circumstances At the time of application and renewal, individuals will be informed that they are responsible for notifying the agency about changes in circumstances that may affect eligibility. Changes may be reported via the ASSIST Self Service website, by telephone, via mail, in person, and through other commonly available electronic means. Eligibility will be redetermined promptly between regularly scheduled renewals when information about a change in circumstance may affect eligibility unless the member is in a continuous eligibility period. See Section 14810.1 How Changes in Circumstances affect Continuous Eligibility. If the agency has information about anticipated changes in a beneficiary’s circumstances that may affect their eligibility, the agency will redetermine eligibility at the appropriate time based on such changes. Failure to report changes that may affect eligibility may result in an overpayment being filed or legal action taken to recover funds expended during periods of ineligibility. 17 DE Reg. 503 (11/01/13) 27 DE Reg. 680 (03/01/24) 14820.1 How Changes in Circumstances affect Continuous Eligibility When a beneficiary is in a continuous eligibility period, coverage may not be terminated due to a change in circumstance, reported by the family or detected through a data match, prior to the regularly scheduled renewal, unless the change of circumstance is an allowable exception. See Section 14810 Continuous Eligibility. 27 DE Reg. 680 (03/01/24) 14830 State To State Transfer Of Medicaid Eligibility Medicaid benefits do not automatically transfer when a Medicaid client moves from one state to another. The Medicaid client must cancel Medicaid in one state and call the new state to establish coverage. In the case of an individual who has moved to Delaware from another State, the individual is no longer a resident of the first State. The individual is ineligible in that State. However, the case may not be closed yet due to administrative process. We must not wait for the case to be closed in the old State of residence in order to open the Medicaid case here in Delaware (the new State of residence) provided the individual has been found eligible here. The fact that a case is open in another State is not sufficient reason to deny or delay an eligibility decision if the individual has established Delaware residency and is otherwise eligible. 14840 Confidentiality Section 1902(a)(7) of the Social Security Act and 42 CFR Subpart F require Medicaid agencies to provide safeguards that restrict the use or disclosure of information about applicants and recipients to purposes directly connected with the administration of the Medicaid Program.