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West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 46 Chapter 10 The Case Maintenance Process

The client must report changes as soon as possible after he becomes aware of them. This allows the Worker to update the case and allows for advance notice, if the reported information results in an adverse action. When a client reports a change during the Medicaid certification period that affects eligibility, the Worker must only request the information on the change reported. For Modified Adjusted Gross Income (MAGI) coverage groups only, when the Worker receives the information, he evaluates the client for rolling redetermination. If the Worker has enough information available to renew eligibility with respect to all the eligibility criteria, he must begin a new 12-month certification period for the client. Client Reporting Example: A redetermination for SNAP benefits is completed on May 14, 2014. The certification period is April 1, 2014, through March 31, 2015. After the SNAP redetermination is completed, the Worker finds the information provided is enough to redetermine Medicaid. The Medicaid certification period is renewed from June 1, 2014, through May 31, 2015. When the Medicaid redetermination is completed and the client(s) remains eligible, the new eligibility period must begin the month immediately following the month of redetermination. 10.6.3 AGENCY TIME LIMITS The Worker must take action on reported changes as soon as possible. When the Worker is aware of anticipated changes that may affect eligibility, the Worker creates an alert in the eligibility system to take action at the appropriate time. See Section 10.7 for Children Under Age 19 Medicaid groups. If the client’s coverage is interrupted due to agency delay or error, procedures for reimbursement of the client’s out-of-pocket expenses may apply. See Corrective Procedures below. 10.6.4 TYPES OF CHANGES 10.6.4.A Change in Case Name