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COMBINED MEDICAID 1501-1 Reporting Changes

Supersedes: CMA 1501-1 (1/1/2025) Reference: 42 CFR 431.213; 42 CFR 435.916 and .919; ARM 37.82.101 Overview: Medicaid clients are required to report changes as soon as possible, but within 10 days of their knowledge of the change. Clients may report changes at any time and are encouraged to report all changes even if they believe the change will not affect their eligibility. All SSI eligible individuals have specific reporting requirements for both SSA and Medicaid. If an SSI Medicaid recipient reports a change to OPA, eligibility staff must act on that change. If the reported change affects SSI eligibility, refer the client to SSA. When changes are not reported or not reported timely, the client may be subject to an overpayment and/or may receive incorrect benefits. Overpayments are evaluated using information as if it had been reported timely, and within the timeliness guidelines.

WHO IS REQUIRED TO REPORT? Anyone receiving, applying, or eligible for Medicaid is required to report changes in both their individual circumstances as well as their household’s circumstances and provide necessary verification. NOTE: The department will evaluate ongoing eligibility in light of the reported change and notify the client if verification is necessary.

WHAT MUST BE REPORTED? Changes that must be reported include: 1. Changes in income source or gross monthly income, including, but not limited to: a. Changes in hours worked or pay per hour/pay period b. Pay raises or pay cuts c. An additional job d. A different job e. Lump sum payments such as lottery winnings, settlements f. Disability/death benefits