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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |100 Effective Month: December 2016 101.01 INTRODUCTION This chapter provides information on coverage of categorically needy individuals in Mississippi and guidelines for processing applications, annual reviews of eligibility, special reviews of eligibility due to reported changes and reinstatements of eligibility for all Medicaid coverage groups and the Children’s Health Insurance Program (CHIP). • Coverage of the categorically needy is either mandatory or optional. Mandatory groups are required by the passage of federal laws and optional groups are authorized by the passage of state laws. • The application process consists of all activities completed during the timely processing period from the time a signed application form is received by the agency until a notice of approval or denial is mailed to the applicant. • An annual review or renewal of eligibility is a full review of all variable eligibility factors, conducted at specific intervals, not to exceed 12 months for each recipient, to determine whether or not eligibility continues. Basic information that is not subject to change is not re-verified. • A special review deals with reported changes that occur during a review period. The impact of each reported change must be evaluated to determine when, how and if the change impacts eligibility. • A reinstatement reopens eligibility without requiring a new application or renewal form. Eligibility may or may not be reopened back to the date of closure, depending on the circumstances. Other changes are also addressed in this chapter that are program specific, such as increases in Medicaid Income and transitioning pregnant women from their original source of eligibility to pregnancy related coverage, when necessary.