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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |505 Effective Month: December 2016 101.15.03 ADMINISTRATIVE RENEWALS An administrative renewal allows eligibility to be renewed based on reliable information contained in the case record and other more current information available to the regional office, such as current data secured from electronic data sources.

• An administrative review must be attempted on every case due for review except ABD cases with a resource test. ABD Medicare cost-sharing cases are renewed administratively, if possible. Exception: if eligibility for QMB, SLMB or QI was initially based on approval of an LIS application, the first annual review must be a full review via the pre-populated renewal process. After the first full review, attempt an administrative renewal for each subsequent review of a Medicare cost-sharing case.

• An administrative review is required annually for SSI-only cases in Long Term Care in COE-005. SSI-only reviews must be completed or, at a minimum, a redetermination contact must be registered, prior to the scheduled mailing of a pre-populated renewal form for the SSI-only case to prevent a pre-populated renewal form from being issued. For SSI-only reviews, the action needed is to verify the individual remains in the facility, check the SDX for any changes and attempt verification of any resources, such as a patient account or other type(s) of resources available to the SSI recipient.

• An administrative review is processed without contacting or requiring information from the MAGI household or Medicare cost-sharing recipient(s). If there is no known change in household circumstances and if all reported income types and sources can be verified through available electronic data sources, use current income verification from these sources to renew eligibility.

• If a MAGI or Medicare cost-sharing case can be approved using current information verified through electronic data sources, the recipient is notified of the approval. A pre-populated renewal form is not generated for administrative renewals.