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BEM 131 3 of 3 HEALTHY KIDS BPB 2022-001 1-1-2022

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

ONGOING ELIGIBILITY Children under 19 (U-19) beneficiaries remain eligible for 12 months of continuous eligibility, unless the beneficiary: • Reaches age 19. • Moves out of state. • Is ineligible due to Institutional Status; see BEM 265. • Is eligible for Foster Care Department Ward (FCDW) coverage. • Dies. Note: If eligibility was granted based on incorrect or fraudulent information, continuous eligibility may be interrupted. Note: An ex parte review is required before Medicaid closures when there is an actual or anticipated change unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories; see BAM 115 and 220. LEGAL BASE MA Social Security Act, Section 1902(a)(10)(A)(i)(IV), Social Security Act XXI, 42 CFR 457.320(A)(2) and (3). 1902(a)(10)(A)(ii)(XIV) 42 CFR 435.229 and 435.4 1905(u)(2)(B) The Affordable Care Act of 2010 is the collective term for the Patient Protection and Affordable Care Act (Publication L. 111-148) and the Health Care and Education Reconciliation Act (Publication L. 111-152).

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Official source

BEM 131 3 of 3 HEALTHY KIDS BPB 2022-001 1-1-2022

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

ONGOING ELIGIBILITY Children under 19 (U-19) beneficiaries remain eligible for 12 months of continuous eligibility, unless the beneficiary: • Reaches age 19. • Moves out of state. • Is ineligible due to Institutional Status; see BEM 265. • Is eligible for Foster Care Department Ward (FCDW) coverage. • Dies. Note: If eligibility was granted based on incorrect or fraudulent information, continuous eligibility may be interrupted. Note: An ex parte review is required before Medicaid closures when there is an actual or anticipated change unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories; see BAM 115 and 220. LEGAL BASE MA Social Security Act, Section 1902(a)(10)(A)(i)(IV), Social Security Act XXI, 42 CFR 457.320(A)(2) and (3). 1902(a)(10)(A)(ii)(XIV) 42 CFR 435.229 and 435.4 1905(u)(2)(B) The Affordable Care Act of 2010 is the collective term for the Patient Protection and Affordable Care Act (Publication L. 111-148) and the Health Care and Education Reconciliation Act (Publication L. 111-152).