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UNOFFICIAL 1713.1-4 (2) The department received a clear written statement signed by the individual or authorized representative that: (A) Medical assistance is no longer wanted; or (B) Provides information that necessitates termination or reduction of services and indicates the individual understands that the consequences of supplying the information is the reduction or termination of assistance; (3) The individual has been admitted or committed to a public institution ineligible to receive medical assistance; (4) The individual is transferred or discharged from a long-term care facility or qualified home and community based home; (5) The individual's whereabouts are unknown and mail sent to the individual has been returned by the post office indicating no known forwarding address; (6) The department has verified the individual's receipt of medical assistance in another jurisdiction, state, territory or commonwealth; (7) A change in the level of medical care is prescribed by the individual’s physician; or (8) Involves an adverse action made in regards to preadmission screening requirements. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§431.206, 431.211, 431.213, 431.214, 435.917) (Imp: HRS §346-14; 42 C.F.R. §§431.206, 431.211, 431.213, 431.214, 435.917)

§17-1713.1-6 Termination of eligibility. (a) The department shall terminate an individual’s eligibility and send notice of the adverse action when: (1) A signed, written request for termination is received from the eligible individual; (2) The department has verified the death of an eligible individual; (3) The eligible individual is admitted or committed to a public institution; (4) The eligible individual is no longer residing in the state;