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Title 8: Medicaid Page 16 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance 90-Day Reconsideration Period Revised November 4, 2022

90-Day Reconsideration Period Legal reference: 42 CFR 435.916, 441 IAC 76.14 (Rules in Process) The reconsideration period is the 90-day period following the Medicaid cancellation date due to failure to submit a Medicaid review form or other information needed to determine continued eligibility at the time of review. Eligibility shall be reconsidered back to the date of cancellation without a new application when the following conditions apply: ▪ Medicaid was canceled for failure to return a completed Medicaid review form or other information needed to review eligibility, and ▪ A completed Medicaid review form is received within 90 days following the effective date of cancellation. If the 90th day falls on a weekend or state holiday, the member shall have until the next business day to provide the review form. The eligibility effective date shall go back to the first day of the first month of ineligibility only if all other eligibility criteria are met for that month. Eligibility for subsequent months within the reconsideration period can still be determined even if the applicant remains ineligible for the initial reconsideration month(s), but eligibility shall not be granted any earlier than the month in which all eligibility criteria are met. For the Qualified Medicare Beneficiaries (QMB), the Home- and Community-Based (HCBS) Waiver groups, and the Program for All-Inclusive Care for the Elderly (PACE), apply the 90-day reconsideration period policy, but treat the review form like an application when establishing the eligibility effective date for these specified groups.