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Title 8: Medicaid Page 36 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Additional Non-MAGI-Related Case Maintenance Revised November 4, 2022 MEPD Case Maintenance MEPD Case Maintenance Legal reference: 441 IAC 75 (Rules in Process) MEPD Reviews Policy: Premiums for Medicaid for employed people with disabilities (MEPD) are established at a fixed monthly rate for a 12-month enrollment period. The MEPD premium may increase or decrease at the time of the eligibility review. However, the premium may increase or decrease during a 12-month enrollment period in specific situations. See Premium Change for Current or Past System Months. Procedure: The ELIAS system issues a Medicaid/State Supp Review, form 470-5482 or 470- 5482(S) to the member 60 days prior to the end of the premium period. After the Medicaid/State Supp Review is returned, process eligibility in ELIAS and issue the Notice of Action. In order to have the correct premium in the system for billing for the new 12-month enrollment period, the review must be processed and the review entries made in the ELIAS system before timely notice of the twelfth month of the current 12-month enrollment period. Review entries made by the 15th of the month will be reflected on the next monthly MEPD Billing Statement. A revised MEPD Billing Statement will be issued when the premium is changed after the 15th but before system cutoff. Review entries made after cutoff will not update the MEPD billing system and a revised MEPD Billing Statement will not be issued until the next regular monthly bill. Premium changes entered in the ELIAS system after cutoff require MEPC entries to revise the premium for the next month. Effect of Nonpayment of Premiums Legal reference: 441 IAC 75 (Rules in Process) Policy: Members who are assessed premiums do not have Medicaid eligibility for a month until a premium payment is applied to that month. Although the due date of a premium payment is generally the 14th of the month for which a premium is assessed, a premium payment may be applied to a month up to three months after the due date. In other words, to become Medicaid-eligible for a month, the client must pay the premium no later than: ▪ Three months after the due date of the premium, or ▪ By the premium due date for retroactive months that were initially billed with a due date three months after the month the MEPD Billing Statement was issued. There is no provision to request a hardship waiver for MEPD.