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Title 8: Medicaid Page 6 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Changes In Household Circumstances Revised November 4, 2022
Changes In Household Circumstances Legal reference: 42 CFR 435.916(d), 441 IAC 76.16 and 76.16(1) Policy: After assistance has been approved, changes occurring during a month are effective the first day of the next calendar month, provided timely notice can be given. When timely notice is required and cannot be given, the effective date is the first day of the second month following the month the change was reported. For exceptions to this policy, see 8-F, Transitional Medicaid. When a change is reported or comes to the attention of the Department, eligibility shall be redetermined regardless of whether the change was required to be reported. Procedure: The following sections explain procedures that apply to all Medicaid households for acting on: ▪ Changes received through IEVS. ▪ Changes received from other sources. ▪ The death of a member. When you become aware of unreported information, the date you receive a signed release for specific information from the member or the date the member otherwise acknowledges the previously unreported information is the date the member reports the change. Do not cancel or deny anyone’s Medicaid due to a failure to supply information about a change in circumstances that does not affect a person’s eligibility. Comment:
Mrs. R and her three children receive Medicaid under a MAGI-related Medicaid coverage group. The youngest is receiving Medicaid as a newborn child of a Medicaid-eligible mother. Mr. R, the father of all three children, returns home and has earnings. The worker requests income verification, but the information is not returned by the due date. The worker cancels the Medicaid for the parents for failure to return requested information. The children remain on Medicaid due to continuous eligibility. See also Additional MAGI-Related Case Maintenance: Adding a New Member to an Existing MAGI-Related Case and Other Changes in the Household, for additional procedures specific to MAGI-related households.