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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 July 2021 Subchapter Subject Page ending with Page M0130 APPLICATION PROCESSING M0130.100 2

5. Delayed Verifications If requested verifications or other information needed to process the case are delayed in the postal system due to no fault of the applicant’s, accept the documentation, reopen the case if necessary, and complete application processing.

M0130.100 Processing Time Standards

A. Processing Time Standards

1. Expedited Application Requirements a. Pregnant Women Applications for pregnant women must be processed within seven (7) calendar days of the agency's receipt of the signed application. If the pregnant woman also applies for other children or other persons in her family and the agency cannot determine the other persons' eligibility within 7 calendar days, the agency must determine just the MA eligibility of the pregnant woman within the 7 calendar days. The agency must have all necessary verifications within the 7 calendar days in order to determine eligibility. If the agency does not receive the verifications within the 7 calendar days, the worker must send the applicant written notice on the 7th day. The notice must state why action on the application was not taken, specify what documentation is necessary in order to determine eligibility, and give a deadline of at least 10 days by which to submit the documentation. Once all necessary verifications for the pregnant woman are received, an eligibility decision must be made immediately and the applicant must be immediately notified of the decision. If the pregnant woman applied for other persons in the family, and the eligibility determination for those persons has not been completed, the written notice must state that the application is still pending. If all necessary verifications are not received, the application continues to pend until the 45-day processing time limit is reached. b. Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) Medicaid Applications BCCPTA Medicaid applications filed by individuals who do not meet the description of an individual in the Low-income Families with Children (LIFC), Medicaid pregnant women, or SSI recipients covered groups must be processed within 10 working days of the agency’s receipt of the signed application.