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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |501 Effective Month: December 2016 101.15.01B PROCESSING CHILDREN CURRENTLY DUE FOR REVIEW If a child, currently due for review, is determined ineligible or will have a program change from Medicaid to CHIP or vice versa, the action must be effective at the end of the current 12 month review period. To process the termination or change in the system, the specialist will enter the month following the child’s review due month as the time span begin date.

Example: The child’s review due date is May. The time span begin date is set for June. If timely action is taken by the adverse action deadline in May, a termination will be effective May 31st. If a program change is involved, action must be taken prior to the end of May. 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 one program to another (Medicaid to CHIP or vice versa) 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.