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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL D-525.2 Division of Welfare and Supportive Services CHANGES Medical Assistance Manual ACTIONS ON CHANGES 24 Jan 25 MTL 02/24

3. Evaluate all electronic verification sources available, prior to requesting verification from the customer. Do not request verification of non-taxable income for MAGI cases.

a. If no electronic data source is available, request verification required to update the case based on the reported change. Allow 10 calendar days from the mailing date for the client/representative to provide requested information.

b. When requested verifications are not provided, terminate assistance allowing for adverse action. If verifications are provided on or before the effective date of closure, reinstate assistance.

4. Document

– the reported change; – the date the change occurred; and – the date the change was reported; and – the actions taken on the case.

5. Re-evaluate eligibility for all medical programs and update the case. If all necessary information is available to complete a redetermination, process the RD and approve an additional 12 months 6. Notify the household of the action taken.

D-525.3 Mass Changes

The state or federal government initiates changes which affect all or a large number of households. Reporting these changes is not required. Mass changes generally occur in:

● the income eligibility standards;

● cost-of-living adjustments (COLA) for Social Security, SSI, VA, and other federal benefits; and

● other eligibility criteria based on legislative or regulatory actions.

Generally, individual notices are produced for automated mass changes whenever a change in the benefit amount occurs.

D-525.4 Additions to the Household

Re-determine eligibility when a new member must be added; If:

● the new member is active in another household, do not add them until they are removed from the other household.

● a new member of the tax filing unit is not reported timely and the change results in a decrease in eligibility, the case is updated the following month, allowing adverse action.

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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL D-525.2 Division of Welfare and Supportive Services CHANGES Medical Assistance Manual ACTIONS ON CHANGES 24 Jan 25 MTL 02/24

3. Evaluate all electronic verification sources available, prior to requesting verification from the customer. Do not request verification of non-taxable income for MAGI cases.

b. When requested verifications are not provided, terminate assistance allowing for adverse action. If verifications are provided on or before the effective date of closure, reinstate assistance.

4. Document

– the reported change; – the date the change occurred; and – the date the change was reported; and – the actions taken on the case.

D-525.3 Mass Changes

The state or federal government initiates changes which affect all or a large number of households. Reporting these changes is not required. Mass changes generally occur in:

● the income eligibility standards;

● cost-of-living adjustments (COLA) for Social Security, SSI, VA, and other federal benefits; and

● other eligibility criteria based on legislative or regulatory actions.

Generally, individual notices are produced for automated mass changes whenever a change in the benefit amount occurs.

D-525.4 Additions to the Household

Re-determine eligibility when a new member must be added; If:

● the new member is active in another household, do not add them until they are removed from the other household.

● a new member of the tax filing unit is not reported timely and the change results in a decrease in eligibility, the case is updated the following month, allowing adverse action.