101.15.01C PROCESSING CHILDREN NOT CURRENTLY DUE FOR REVIEW

Each child must be provided 12 months of continuous eligibility in his eligible category. Prior to the end of the 12-month period, a child cannot be: • Terminated, unless an early termination reason exists, or • Changed from Medicaid to CHIP unless the parent or other authorized person voluntarily requests early closure in the current program, or the original determination was in error. When reviewing a case with different review due dates and the current review is for the person with the earliest review due date, it is appropriate to set a redetermination contact for all case members; however, the current review and any requests for information must be focused on the case member(s) due for review. Do not request any information on any children with a future review due date. If updated information is provided during the review which results in eligibility for all case members, eligibility can be extended for all members, including children with a future review due date. If updated information results in ineligibility for any child with a review due date in the future, it is not possible to take action to terminate eligibility prior to the end of the 12-month continuous period. Future termination dates for children not currently due for review are not permitted. Instead, the child or children must be fully reviewed at the end of the 12-month protected period of eligibility. This includes a deemed eligible newborn who is eligible for the first full year of life. Retract eligibility and cancel the redetermination contact for any children affected by a finding of ineligibility. When a program change is involved for a child with a future review date, the change from Medicaid to CHIP cannot be made until the end of the child’s current eligibility period unless the parent or other authorized person consents to early termination in the current program. The change must be reported to the parent or other authorized person by DOM, and consent for the program change must be documented in the case narrative. Changes from CHIP to Medicaid must be acted on. Retract eligibility and cancel the redetermination contact for any children affected by a change from Medicaid to CHIP that has not been approved.