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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 75 Effective Month: September 2023

101.15.01A FREQUENCY OF REVIEWS A full review must be conducted for all eligible household members (MAGI and ABD) at the earliest 12-month review when case members have different review due dates. When a redetermination is currently due for some but not all case members, a redetermination contact will be set on everyone to attempt to align redetermination dates for the following year and assure one annual review for case members:

• Adults in the case can have their 12-month review period shortened by a change in circumstances that affects adult(s) in the case. The exception is a pregnant adult who is eligible in any COE. • Children that are not due for review require special handling to ensure protection of their 12-months of continuous eligibility, as described in 101.16.01B and 101.16.01C below.

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 , 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.