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COMAR 10.09.24.04

323 State of Maryland Medical Assistance Manual Revised July 2012

o The applicant is actively attempting to establish his/her eligibility but has been unable to provide the required information through no fault of their own o There is an administrative or other emergency beyond the control of the LDSS

If any one of the above condition exist, the period of time allowed to complete the application must be extended.

The CM shall document the reason for the delay in the applicant records The extension of time will continue as long as the requirements are met. The CM shall deny medical assistance when these requirements are not met

(1) Explanation

In order for an applicant to meet eligibility requirements, he/she must be told what information must be provided and the due date. This requirement presumes that the applicant has disclosed all information pertinent to his/her eligibility before or during the face-to-face interview. If an applicant fails to disclose pertinent information before or during the face-to-face interview and the failure cause local department delay in requesting verifications, the extension of time does not apply; however, if the applicant is determined ineligible and reapplies before the period expires, the case must be evaluated under the reactivation procedures.

If all pertinent information is reported to the local department no later that the date of the face-to-face interview, the local department is obligated to provide the applicant a written list of all the verifications( financial and non-financial) that are needed to determine eligibility. If the local department fails to do so, the local department must take that fact into account deciding whether or not the applicant can be expected to complete the requirements within the 30 or 60-day time frame.

The time standards are binding on both applicant and local department. It is necessary that local departments make decisions and send a written notice to applicants at the appropriate time, whether the standard time frames or an extension of time applies.

(2) Explanation of Justification Requirements for Extension of Time

The reactivation process may not be substituted for the extension of time standards when it is appropriate to extend the time standards. It is appropriate to extend the time standards when an applicant has been unable to provide the required information through no fault of his/her own and the applicant provides written documentation of that fact, or the local department is able to verify in some way that the applicant did not delay the request for information. Most required information is obtainable within a period of 7 working days or less. Some examples of the kinds of information, that may not be readily available to an applicant through no fault of his/her own are:

The exact cash value of a life insurance policy when that information is not available in the local office of the insurance company; An independent appraisal of real property, A physician’s report for disability determinations; or