Page 83

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |83 Effective Month: July 2025 of failure to assign rights or lack of cooperation in obtaining third party payments, without good cause, will result in denial or termination of Medicaid benefits after affording the right to appeal. If the TPR Unit determines an individual has failed, without good cause, to cooperate with third party assignment, The Office of Eligibility will be notified. In turn, the appropriate Regional Office will be notified of the action needed to deny or terminate eligibility. Advance notice must be issued to terminate eligibility; however, the individual has the right to a hearing. All appeals regarding failure to cooperate with the TPR Unit must be handled through a state hearing request. When benefits are terminated due to failure to cooperate with TPR, the RO will be notified of the period of ineligibility. If the cooperation issue is resolved with TPR, the RO will be notified of the action necessary to restore eligibility. 102.08.05A CHIP AND OTHER INSURANCE COVERAGE Children who are covered by creditable third-party insurance at application are not eligible for CHIP, regardless of who pays the health insurance premiums. Creditable third-party insurance includes coverage under any of the following: • Job based group health plans, • Any health plan through the Health Insurance Marketplace, • Individual health insurance, • Most student health plans, • Health coverage for Peace Corps volunteers, • Medicare, Medicaid, CHIP, • CHAMPUS, TRICARE and veterans’ health coverage through the VA, • The Federal Employees Health Benefits Program, • Health coverage through the Indian Health Service, • Any plan established or maintained by a State, the U.S. government or a foreign country. • A state health insurance high risk pool, Termination of creditable coverage must be verified when the application indicates insurance coverage will terminate within the 30-day application processing period or