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COMAR 10.09.24.12

1204 State of Maryland Medical Assistance Manual Revised July 2012 period under consideration, the CM must send the application manually. Cases that are still in preserved status at the end of the period will not receive an application.

(2)Period under Consideration

The twelve month redetermination period should not be confused with the “period under consideration”, or budget period. The period under consideration is the period of time during which income may be considered, and is limited to six months by federal regulation. The period may be shortened, but may not be lengthened. When determining income eligibility, only income received during the six month period may be considered. Circumstances where the period under consideration is shortened include retroactive determinations and determinations for deceased applicants. While this rule has the greatest impact on spend-down cases, it is applicable in all other cases.

When determining eligibility, the six month period under consideration begins with the month of application. If income is within the standard and the applicant is determined eligible, the assumption is made that income will remain within the standard during the next period under consideration; therefore it is not necessary to complete a redetermination at the end of each period under consideration. An exception to making this assumption is when a change of income can be reasonably anticipated. In that case, the CM should set a “745” alert to confirm income at a particular point and redetermine eligibility if necessary. The second exception is when an actual change of income is reported. A change must be acted upon, regardless of the income previously calculated. A third exception to the assumption is where a retroactive determination has been made. Current eligibility is always determined separately from the retroactive period.

(3) Certification Period

Certification period refers to the actual begin and end dates for eligibility that appear on MMIS. These begin and end dates are transmitted by CARES to MMIS through the automated interface, and may not match the end date or redetermination dates shown in CARES on the MAFI screen. Programming between the two systems has been carefully coordinated to ensure that all recipients receive the correct periods of eligibility.

Note: When the end date on MMIS appears as “999999”, this means there is actually no end date, and that eligibility will continue until CARES transmits an actual end date.

Coverage Group Code CARES Redet Date MMIS End Date Budget Period Redet Process Re- Application F01

12 None None X

F02

12 None 6 X

F03 4 None 6 X

F04

12 None 6 X