loading…
loading…
loading…
COMAR 10.09.24.01-.16 1720 State of Maryland Medical Assistance Manual Revised July 2012
(7) Recipients shall cooperate with the State's Quality Control review process, including provision and verification of all information pertinent to eligibility determination. Failure to cooperate shall result in the following actions:
(a) The Quality Control Division shall notify the local department of social services of a recipient's failure to cooperate;
(b) The local department of social services shall immediately attempt to secure the recipient's cooperation;
(c) If the recipient still refuses to cooperate, his coverage shall be terminated in accordance with this provision, subject to the regulation governing timely and adequate notice.
C. Redeterminations.
(1) Redetermination for Former SSI Recipients.
(a) The local department of social services shall promptly redetermine eligibility when notice has been received from the Social Security Administration that a person's SSI benefits have been terminated.
(b) When notice of SSI termination is received, the local department of social services shall notify the person that redetermination is required to establish continuing eligibility and shall make the application available to him.
(c) When the written, signed application is received by the local department of social services, a new period under consideration will be set. The new period will be related to the date the application is received but may not include any months in which the person was entitled to coverage under the current certification period.
(d) The local department of social services shall notify the person or his representative of the required information and verifications needed to determine eligibility and the time standards in acting in the redetermination process.
(e) The local department of social services shall require the recipient or his representative to appear in person unless the local department of social services has determined that face-to-face contact is not necessary to make an accurate eligibility determination.
(f) All non-financial and financial factors for continuing eligibility shall be met.
(g) The following applies when the person is determined ineligible for Medical Assistance:
(i) When the SSI termination is received by the tenth day of the month, the local department of social services shall cancel certification effective the end of the month, unless the recipient requests a hearing in accordance with Regulation .13 of this chapter.
(ii) When the SSI termination notice is received after the tenth day of the month, the local department of social services shall cancel certification effective the end of the following month