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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page 117

Effective Month: March 2018 ACTION POLICY REQUIREMENT PROCEDURAL REQUIREMENTS 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. 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) 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 • Switch from CHIP to Medicaid or Medicaid to CHIP Advance Notice = 15 full days following the date an adverse action is taken on a case. Medicaid Income increase is the exception. Advance Notice to Increase Medicaid Income Advance notice is 10-days before the date DOM makes its payment to the nursing facility, which is always in the month following the current month. Advance notice is 10 calendar days before the 1st of the following month for the change to be effective