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This page last updated in Release Number: 25-04 Release Date: 12/10/2025 Effective Date: 12/10/2025 20.8 Actions 20.8.1 Positive Actions Benefits will begin or continue when: • The member has submitted a timely renewal which remains in progress over adverse action of the renewal month. • The member submitted a timely renewal after adverse action but by the last business day of the renewal month. • The member has a change in circumstance and verification is requested to determine eligibility for other forms of health care. • The member provides requested verification within the specified time limits and is otherwise eligible. • Requested verification is mandatory, but the member does not have the power to produce the verification and he or she is otherwise eligible. In this situation, the agency must also make an effort to obtain the verification (see SECTION 20.1.4 GENERAL RULES). 20.8.2 Delay Applicants must be notified of a processing delay when: • Verification is needed. • The applicant has the power to produce the verification. • The minimum time period allowed for producing the verification has not passed. • Additional time is needed to produce the verification. A notice is sent to the applicant indicating the reason for the delay, the specific verification required, and the date the verification is due. If eligibility is maintained following a timely renewal with pending verification, a notice is generated to explain health care benefits are being maintained during the redetermination. 20.8.3 Negative Actions Benefits will be denied or reduced when all of the following are true: • The member has been tested for all categories of health care and is determined ineligible. • The applicant or member has the power to produce the verification. • The time allowed to produce the verification has passed. • The applicant or member has been given adequate notice of the verification required. • The requested verification is needed to determine current eligibility. Current eligibility cannot be denied for lack of verification of a past circumstance that does not affect current eligibility. • The member is not a child in a continuous coverage period (see SECTION 1.2 CONTINUOUS COVERAGE FOR QUALIFYING CHILDREN).