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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page 954 Effective Month: March 2018 Assigning Review Due Month at Redetermination MAGI and ABD are determined using the time period begin month to start the 12-month count. Begin month of time period + 11 months = review due date.

Administrative Renewal Processing If eligibility can be approved in the same program (Medicaid or CHIP or ABD in the same COE) based on updated data from electronic data sources and reliable case record information then the recipient is notified of the approval and asked to report any changes. Any changes reported are acted on as part of the redetermination process. ABD cases with an asset test are not renewed through this process. Adm. renewals must be initiated before scheduled mailings of pre-populated forms. Processing Renewals Using Pre-populated Review Forms Pre-populated renewal forms are issued by MEDS for MAGI & ABD cases. Due date for return of the signed form MAGI form is 30- days and ABD is 20 days from date form is issued. Returned forms with missing information require the use of a309 for ABD and telephone contact for MAGI. New or additional information requires use of 307 (MAGI) and 307/309 (ABD). Must attempt telephone contact prior to terminating (for MAGI and ABD) to try to secure missing information.

Refer to the Reinstatement policy for compliance after termination. Timely Authorization of a Renewal Review is timely if authorized by the last day of the month in which review is due. If case is closed, action to close must be authorized by the adverse action deadline date.

Reviews are considered overdue if not authorized timely. Adverse Action Deadline(s) for Advance Notice Advance notice (10-days) is required to take an adverse action. The deadline is the 15th day of the current month (exception is February – deadline is the 13th) in order to allow 10-days advance notice plus 5-days mailing time.

Adverse action must be authorized on or before the deadline date to be effective the following month. Advance Notice to Reduce or Terminate Benefits Advance notice is required to: • Terminate eligibility • Convert a case to a reduced services COE (QMB, SLMB, QI) • Terminate a nursing facility per diem payment Advance Notice = 15 full days following the date an adverse action is taken on a case. Medicaid Income increase is the exception.