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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 | 81 Effective Month: September 2023 • If an ex parte review does not result in an approval in the same or better program, a pre-populated form must be issued to allow the recipient to provide current information. It is possible to move a beneficiary from one Medicaid program to another Medicaid program that provides the same or better coverage based on an administrative ex parte review; however, a child cannot go from Medicaid to CHIP or CHIP to Medicaid. • If some household members due for a review can be renewed ex parte, but other household members due for a review cannot, a prepopulated form must be issued. The household members eligible for an ex parte review must be renewed ex parte when the review form is returned. If the form is not returned, the household members eligible for ex parte review still must be renewed ex parte. • If a recipient reports a change in response to an administrative ex parte renewal approval, document all changes on the “Administrative Review Contact Documentation” form located in the Appendix page by the same name. Attempt verification of a reported change through electronic data sources before requesting information directly from the recipient. • Handle reported changes as a redetermination contact in the system. The appropriate approval or denial notice will be issued based on the outcome of the reported change. Children may not be terminated or switched from Medicaid to CHIP due to a reported change after an ex parte review is completed. • Automated generation of pre-populated review forms take place on a schedule that is published annually and is based on the review due month. Ex parte renewals must be registered as a redetermination contact with a time period pending before the scheduled generation of a pre-populated form. Medicare cost-sharing cases marked “Yes” under “reduced Coverage Adm Review Criteria Met” on the RJ831 and RJ831w will not have an automated prepopulated review form mailed by MEDS. These cases will require a manual prepopulated form to be mailed if an administrative ex parte review cannot be completed.