Page 20

Title 8: Medicaid Page 18 Iowa Department of Health and Human Services Employees’ Manual Chapter B: Application Processing Processing Standards Revised October 17, 2025 Guidelines for All Applications When the application is for non-MAGI-related Medicaid, including non- MAGI-related Medically Needy, and a blindness or disability determination is pending, the time limit is 90 days. See Concurrent Medicaid and Social Security Disability Determinations. If a person’s eligibility is dependent upon a 30-day period of residency in a medical institution, delay the eligibility decision until the 30-day period has been met, unless the person is ineligible due to some other factor. The time limit for approving or denying a Medicaid application can be waived in unusual circumstances. Examples of unusual circumstances include:  You and the applicant have made every reasonable effort to get necessary information but have not been able to do so within the time frames.  Retroactive Medicaid was requested for a person whose proof of citizenship and identity has not yet been provided as described in 8-C, Reasonable Opportunity Period.  Emergencies, such as fire or flood.  Other conditions beyond the administrative control of the local office. You must document the reason for the delay. You cannot deny an application because of the time period alone. To deny the application, there must be either failure to act on the part of the applicant or a determination of ineligibility. An applicant must cooperate with the application process. This may include providing information or verification, attending required interviews or signing documents. Failure to cooperate with the application process shall serve as a basis to deny an application. Unnecessary Application Legal reference: 42 CFR 435.912, Iowa Code Section 249A.4, 441 IAC 441 7.7(1) A Notice of Decision or a Notice of Action must be issued to approve or deny all applications, including unnecessary applications.