Verification is NOT Returned

Reasonable opportunity applies to each individual AU member rather than the entire AU. If an applicant/recipient does not return verification of citizenship/identity by the beginning of the third month following the month of approval, the individual for whom citizenship/identity has not been verified should be penalized (an adult) or excluded (a child) from the Medical Assistance AU at the end of the ROP. Refer to 2657 Penalized Individuals . The change must be completed in time for timely notice to expire no later than the end of the third month.

If verification for the penalized or excluded applicant/recipient is returned after the closure but before the end of the third month, the individual should be reinstated. Citizenship/identity verification for a penalized or excluded AU member who received an ROP can be provided at any time during the 12-month period following the expiration of the ROP. No new application is required when removing the penalty or adding the child back to the original Medical Assistance AU. The previously penalized or excluded A/R should be added back to the Medical Assistance AU effective the first day of the month that verification is provided.

In the following situations, a new application is required if verification of citizenship/identity is provided during the 12-month period following the ROP.

A Medical Assistance case in which there is only one AU member

A Parent/Caretaker case that contains only one eligible child and the child’s verification of citizenship/identity is not provided. In this situation, the case would have closed as there would be no qualifying child in the AU under 19.