101.11.02 EXCEPTIONS TO ADVANCE NOTICE

Unless noted, the following actions require notification to the recipient; however, 15-day advance notice is not required. Death When the agency has factual information verifying the death of a recipient, the date of death and verification source must be recorded in the record. A notice is not generated by the system if the termination reason is death. Some acceptable sources to verify the death date are: • SVES, SDX, or EVVE • Report from recipient’s representative or the MAGI Head of Household. • Viewing the death certificate. • Contact with the funeral home or the attending physician. • DOM-317 from the nursing home or contact with the hospital or nursing home where the patient died. • Obituary. Loss of State Residence When the agency establishes that a recipient has moved from the state through information received from the recipient or because another state reports the client has been accepted as a resident for Medicaid in that state, advance notice of closure is not required. Resident of a Public Institution When the agency has established that the recipient has been admitted to a public institution, such as a prison or a state hospital in a non-Title XIX facility, advance notice of termination is not required. Unable to Locate When a recipient’s whereabouts are unknown, the agency must take reasonable efforts to locate the recipient. When agency mail is returned by the post office with no forwarding address and other efforts to locate the recipient are unsuccessful, eligibility will be terminated. However, if the client’s whereabouts subsequently become known during the time the client is eligible for services, the case must be reinstated. Voluntary Request for Closure If the recipient or his designated representative voluntarily requests closure, advance notice is not required. If the request is made in person, the specialist will obtain the request in writing. Otherwise, the specialist will document the case to reflect the specifics of the request. Eligible for Medicaid through Another Source If a MAGI-related or ABD recipient becomes Medicaid-eligible through SSI or foster care, advance notice of termination of benefits authorized through the Medicaid Regional Office is not required.