Page 43

The individual’s receipt of a one-time payment will cause ineligibility for a month. Inability to verify eligibility for a month. Suspension Procedures – Ineligible for One Month Only The worker must: Document the ineligibility, the suspension, and the reason for it in the case record. Assure substantiation of ineligibility is included in the case record. Example: If the individual is ineligible due to excess income, the case record must include verification of the income and the calculations used to determine ineligibility. Evaluate Medicaid eligibility based on the Medicaid Manual. If Medicaid eligible Document the change in the case record assuring that each changed eligibility factor is addressed. Assure that all supporting verifications are in the case record. Close the AG Medicaid case VaCMS. Reopen the individual in his new Medicaid covered group in VaCMS. Send a “Notice of Action (for AG)” to the individual and his representative to notify them that Medicaid eligibility continues. If Medicaid ineligible Document the closure and the reason for it in the case record. Assure substantiation of ineligibility is included in the case record. Example: If the individual is ineligible due to excess income, the