101.16 SPECIAL REVIEWS

A special case review is completed when changes occur between regular reviews, which may result in adjustments to eligibility or benefit level. A special case review is not a full review. Instead, the case (or an individual) is evaluated to consider the impact of the changed information. Factors unrelated to the change are not re-verified as part of a special review. Example: A COE-075 adult recipient reports three months after her regular redetermination that she has a part-time job. The children in the case have income from Social Security which was last verified at the regular review. The Social Security income is not subject to re-verification since it is not part of the reported change. A special review of eligibility is required when: • The recipient reports a change in circumstances which could affect eligibility and benefit level. • Information is received from any other source which could affect eligibility and benefit level. • Potential changes in eligibility are indicated by information available to the agency. The special review process may result in termination of benefits, benefit reduction or adjustments to Medicaid Income. It may also involve procedural changes, i.e., updating or correcting case information with no impact on eligibility or benefits. Special reviews are handled differently, depending on the impact the change may have on eligibility and is discussed below.