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State of Maryland Medical Assistance Manual Revised April 2014

The LDSS may need to make interim changes (changes that occur between scheduled redeterminations). A change in income, resources, deductions, cost of care, or institutionalized status may affect available income and eligibility. A. Timely Reporting, Local Department of Social Services (LDSS) and Notification • A person must report any change in resources, income, deductions, or institutionalized status within 10 working days of the change. • The LDSS must act on any change no later than 30 days from the date the change is reported. • The LDSS must provide written notification to the recipient, representative, and LTCF regarding any change in available income or eligibility. Notification of a change in available income must be sent before or at the same time the LDSS notifies the LTCF of the change. If a change results in ineligibility for MA, timely notice must be given before MA is cancelled. B. Changes Not Reported in a Timely Manner If a change is not reported to the LDSS in a timely manner and results in increased available income or ineligibility for Medical Assistance, the LDSS must act upon the change within 30 days of the date the change became known. 1. Adjust available income or cancel payment to the facility effective the month the change became known to the LDSS. 2. Make a referral for investigation and recovery using DHMH 4243form. The Recoveries unit will determine the appropriate action to recover funds improperly paid by the Program. 3. If a change results in ineligibility, close the case with a 10-day timely notice period. 4. If the change results in decreased available income but the person failed to report it in a timely manner, make the change effective the month in which the change was reported, but not retroactively to the month of change.

C. Changes Not Acted Upon in a Timely Manner Under certain circumstances the LDSS may find it administratively impossible to act on a change in a timely manner. The LDSS is in error if, for any reason, it fails to act on a change within 30 days of learning of the change. When a change results in ineligibility or increased available income, the agency may not affect the change retroactively to the month it occurred nor to the month it was reported. Increased available income may be effective no earlier than the month in which the agency takes action. If the change results in ineligibility for MA, timely notice must be given before MA may be cancelled. This delayed action results in improper payments by the Program; therefore, this must be reported for recovery using the DHMH 1169 form. When a change reported in a timely manner results in decreased available income, the LDSS must adjust the available income retroactively to the month it becomes effective. If the change was not