Page 13

Title 8: Medicaid Page 10 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Changes In Household Circumstances Revised November 4, 2022 Acting On IEVS Information On a Community Spouse Acting On IEVS Information On a Community Spouse IEVS reports are sent for all people whose names and identifying information have been pended on the ABC system, including a community spouse. Do not delay processing eligibility if the IEVS report is not received within the 30-day-processing period. If Medicaid is approved for the institutionalized spouse, leave the community spouse pended. You should receive an IEVS report on the community spouse as well as on the applicant. If the Medicaid case is denied for the institutionalized spouse, or only an attribution is completed, leave both cases pending for Medicaid. Manually issue the Notice of Attribution. If the Medicaid case is denied, manually issue a notice denying the Medicaid. An IEVS report should be issued for all pending cases. If there is no IEVS report within 60 days, close the pended case. There is no match for IEVS. If you believe that an IEVS report will not be forthcoming for either the applicant or the community spouse, document this in the case record. When you receive the IEVS report, compare the resources that are made known with reported resources. If the attribution needs to be corrected, manually issue a Notice of Decision to correct the attributed amounts. Acting on Changes Received From Other Sources Legal reference: 42 CFR 435.952(a), 441 IAC 76.14(2) When you receive a report from sources other than the client indicating that there may be unreported income or resources that may affect eligibility, contact the client to ascertain the facts and then determine the effect on eligibility. If the subject of the report is an SSI-eligible person, forward the information to the Social Security Administration. Investigate only when the client is an institutionalized spouse with a community spouse. The client must provide requested verification. See Supplying Information and Verification. You may also receive notification from the Iowa Medicaid Enterprise that a Medicaid member is eligible for Medicare Part A and B when this is not reflected on the current eligibility file. Verify the coverage with the Social Security Administration or with Bendex. If an update is needed in the “Medicaid Resource Section” of the eligibility file, complete form 470- 0397, Request for Special Update, according to the instructions in 6-Appendix.