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Chapter: 2400 Budgeting Income Program: MSSI, SFP 44 2440.0800 EXPLORING MANAGEMENT (MSSI, SFP) Management is the comparison of the monthly income received and expenses paid by the applicant or recipient. In exploring eligibility, an applicant or recipient is required at a minimum to explain management during the month(s) of application and at each complete eligibility review, if questionable.

This policy applies to MEDS AD, NS, QMB, SLMB, QI-1, Protected Medicaid, Working Disabled, EMA, Community Hospice:

An applicant is required to explain management for the month(s) of application and may be required to explain management for months prior to the month of application. A recipient is required to explain management if questionable for the month of complete eligibility review and may be required to explain management during the review period. An application cannot be rejected for failure to provide documentation of expenses paid in months prior to application; however, failure to explain management during the month(s) of application may result in denial of the application if eligibility cannot be determined.

When current paid expenses exceed acknowledged income, receipt of income from other possible sources must be explored by the eligibility specialist and verification or documentation secured by the individual, if indicated.

If the applicant or recipient cannot explain how the bills were paid, the case should not be denied or canceled solely on “management”. However, the eligibility specialist must request that the applicant or recipient furnish additional information, that is, pend the case. Failure by the applicant or recipient to provide this information within the pending deadlines will result in the case being denied based on the fact that eligibility cannot be determined.

This policy applies to ICP, institutional Hospice and HCBS:

It is possible to identify undisclosed income and assets through examination of the individual's living situation and financial management. It is of primary importance to examine how the individual lived and met expenses in the one year prior to their application for assistance.

For ICP, allegations of disposed assets or unavailable income must be confirmed. If the information provided by the applicant or recipient indicates the existence of unstated income or assets (that is, there is a question of how the individual met daily living expenses), the eligibility specialist must ask for an explanation and record the details. Assistance with the case should be requested from the Region or Circuit Program Office.