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• A signed and completed Medicaid Disability Redetermination Report (F-10114). • A signed and completed Authorization to Disclose Information to Disability Determination Bureau (DDB) form, F-14014 • From the existing Electronic Case File (ECF), the original Disability Determination form (SSA-831), any subsequent disability determinations, and all prior medical evidence and forms. DDB will make a decision, which will be indicated on a Cessation or Continuance of Disability form (SSA- 832). • Item 9 (SSA-832) indicates the decision of (A) continuing or (B) ceased. • Item 23B (SSA-832) indicates a medical re-examination date when necessary. If the member’s disability is found to continue, the DDB will send an approval response, which includes the SSA-832 form which is stored in the ECF for the IM agency to review. If DDB determines that the member is no longer disabled, DDB will first send written notice to the member explaining the basis for the proposed decision and offering the right to appeal. Appeal forms are enclosed with this letter, and members are told that completed appeal forms must be mailed directly to DDB and be received within 45 days of the date on the letter. Members are also told that if a timely appeal is filed, Medicaid benefits will continue until a hearing is held and a decision is made. DDB will temporarily retain the SSA-832 in these cases. If the member appeals the proposed cessation and DDB is able to reverse the decision to a continuance, an approval response will be sent electronically at that time and a revised SSA-832 will be stored in ECF. If the member appeals the proposed cessation and DDB is unable to reverse this decision, the file will be forwarded directly to the DHA for a hearing. DHA will notify the IM agency of its final decision. If the member chooses not to appeal or fails to file the appeal on a timely basis, DDB will send documentation to ECF that contains the original SSA-832 following the expiration of the 45-day appeal period. DDB will add a Medicaid Disability Cessation Case indicator to the document to highlight these cases. See SECTION 5.7.1.1 EXAMPLE OF MEDICAID DISABILITY CESSATION CASE NOTICE TEXT for an example. Once the IM agency receives final notice of a cessation, then they must follow existing procedures to notify the member of the termination of Medicaid benefits (unless the member qualifies for health care on some other basis). The member will be given another 45 days to appeal that decision. Note The process described above provides the Medicaid member with two opportunities to file an appeal regarding whether or not he or she continues to be disabled. This is the result of federal laws that require the DDB to notify a disabled member who receives Medicaid benefits or Social Security benefits that he or she no longer meets the disability criteria necessary to continue receiving those benefits. These notice requirements for DDB also include an opportunity for the member to appeal the DDB decision within 45 days. Medicaid benefits must be continued during this potential 45-day appeal period, whether or not the client actually files an appeal. DDB cannot notify the IM agency that the client is no longer disabled until this 45-day appeal period has expired, and the client did not file an appeal within that time frame. Once this initial 45-day appeal period expires, with no appeal request from the client, DDB will then notify the IM agency that the Medicaid member is no longer disabled. Upon receipt of the notification of Medicaid Disability Cessation from DDB, the IM agency must then redetermine whether or not the member qualifies for any other category of health care not related to disability. If the member is not eligible for any other health care category, the IM agency takes the necessary action to discontinue the member’s Medicaid eligibility in the normal manner, issuing all