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COMAR 10.09.24.12

1215 State of Maryland Medical Assistance Manual Revised July 2012 A recipient shall be treated the same as an applicant at the time of scheduled redetermination. All non-financial and financial factors of eligibility shall be met. The LDSS shall make timely decisions in accordance with the provisions of Regulation .04L of this chapter.

o Eligibility Decisions: o Eligibility Established - Applicants who are determined eligible for a new period under consideration shall be sent adequate and timely notice. o Ineligibility Established - Applicants determined ineligible for the new period under consideration shall be sent adequate and timely notice.

When ineligibility is due to excess income only, the applicant will be provided with an explanation of the spend-down provision. Spend-down eligibility may be established at any time during the new period under consideration.

The application, when filed by the recipient at any time within the last 45 days of the certification period, establishes a consideration period of six months which begins with the first day of the month following the last month of certification. No retroactive consideration period based on the application filed within the last 45 days of the certification period is allowed. A face-to-face interview is not required unless the local department decides that it cannot make an accurate determination without an interview.

The recipient must provide information about current income, current-resource, identify unit composition, or any non-financial eligibility factors. The CM must identify required verifications and give the recipient a deadline for supplying them. This deadline should precede the end of the current certification period so that the CM has some time to evaluate submitted verifications, determine eligibility before the expiration of the current certification period, and record continuing eligibility without delay for those recipients who remain eligible for Medical Assistance.

The extensions of the basic time limits available to initial applicants (see Regulation .04I (4)) also apply to re-applicants and must be kept in mind when establishing deadlines for submission of information. Any deadlines established for submission of verifications may not be adhered to so rigidly that the local department refuses to accept and evaluate verifications submitted after the established deadline but before the end of the current certification period. However, the recipient should be advised at the time the deadlines for submission of verifications is established that some interruption in coverage may occur if he does not submit the required verifications before the deadline.

Subsequent Application. A person may reapply when eligibility is not met during the periods established in SC (1) and (3) of this regulation.

1200.3 Certification of Creditable Coverage