Page 98

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page | 98 Effective Month: September 2023 • A negative change reported during a review period that affects eligibility for adult(s) is handled at the time of the reported change; however, it is not permissible to take punitive action on the children in a case due to action being taken for the adult’s eligibility. This includes not setting future termination dates for the children at the end of their 12-months of continuous eligibility. Children must be reviewed so their eligibility is assessed at each annual review. For example, an adult reports marriage and is terminated during the review period because spousal wages were requested but not verified. The non pregnant adult’s eligibility is terminated. A future closure would not be set for the children. The child’s eligibility must be reviewed at the next annual review. If information needed at the time of the annual review is not provided, the children’s eligibility would be terminated as a result of the annual review. • If there is a case change, such as the addition of a parent, that results in information that must be requested to confirm the parent’s eligibility, do not require updated information for a child’s eligibility. Handle the child’s eligibility at the next annual review. • Reported changes that will not likely affect eligibility for the household should be developed but if a request for additional information yields no response, it is not permissible to terminate eligibility for a failure to respond to the request. Instead, follow up at the next review. These types of changes may include a change of address for the household when a move out of state is not indicated, loss of an income source to the household, the death of a child’s parent or other types of changes that would not result in a loss of eligibility. • Reported changes or actions taken during a review period can affect one or more household members but not the entire household. The option to perform an early review can be offered but cannot be required for a child’s eligibility. • A change during the review period that results in updated information on all household members can result in eligibility being extended for the household. For example, during the review period a parent applies and is added to the case. All household income is updated and verified. It is permissible to extend eligibility for a new 12-month review period for the children under these circumstances.