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Title 8: Medicaid Page 18 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Automatic Redetermination Revised November 4, 2022 Additional Information for Non-MAGI-Related Redeterminations ▪ If the client returns verification by the due date on the Notice of Cancellation/ Redetermination, complete the redetermination and issue a Notice of Action. ▪ If the client does not return verification but has a legitimate reason not to supply verification by the due date, you can grant an extension but the cancellation remains in effect. If verification is received by the second due date, treat it as though it was received timely. Complete the redetermination and issue a Notice of Action. ▪ If the client does not return verification and you have not granted an extension, do not do anything further. Do not send a Notice of Action, because the client already received a Notice of Cancellation/Redetermination. If you receive an SDX from the Social Security Administration and the payment status is N01, use the SDX as income verification when completing the automatic redetermination. NOTE: Some people in an N01 payment status may be eligible for the 1619b coverage group. See 8-F, People Ineligible for SSI (or SSA): Due to Earnings Too High for an SSI Cash Payment (1619b Group). If the client is canceled from SSI for being over resources, status N04, call the Social Security Administration to determine the amount of resources. If resources are within Medicaid limits, document the contact and complete the redetermination process. Use the SDX for resource verification. If resources are not within Medicaid limits, contact the client and request verification of resources. Keep adequate documentation in the case record to show that a redetermination was completed. Document what steps were taken to complete the process and the results of that process. If a client files a timely appeal and reinstatement of eligibility is required, reinstate to the coverage group under appeal until a final decision is reached. Additional Information for Non-MAGI-Related Redeterminations For SSI-related redeterminations, eligibility under a new coverage group is usually apparent. The only time it should be necessary to use the automatic redetermination aid type is when you need additional information to make a redetermination. This affects mainly: ▪ SSI recipients living in their own homes who lose SSI eligibility due to excess income. ▪ People in the 300% group who return to their own homes from a medical facility. ▪ People returning home from a residential care facility.