2122 Application and Review Process

To determine eligibility, the application form must be completed and signed, and certain information on the application must be verified. If denied or terminated for refusal to cooperate, the client may reapply but shall not be determined eligible until he or she cooperates.

The client shall also be determined ineligible if he or she refuses to cooperate in any subsequent review of its eligibility, including reviews generated by reported changes and recertification. For medical, the formal review requirement does not apply to pregnant women and children under the age of 1 who have continuous eligibility under the Medicaid program or are eligible under the SI program. In instances where a pre-populated review is sent for an individual with a passive review type, return of the review is not a requirement for the individual with the passive review type.