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West Virginia Income Maintenance Manual Chapter 2

West Virginia Income Maintenance Manual Page 13 Chapter 2 Common Eligibility Requirements

2.4 COOPERATION WITH QUALITY CONTROL A recipient of Supplemental Nutrition Assistance Program (SNAP) benefits and/or Medicaid is required to cooperate with Quality Control (QC) if selected for a QC review. 2.4.1 Refusal to Cooperate When a client refuses to participate or cooperate in the review, the benefit for which the QC review was attempted must be stopped after advance notice, except for Medicaid coverage for children, pregnant women, and Supplemental Security Income (SSI) clients. A sanction is applied to the pregnant woman after the postpartum period, even when she qualifies for another Medicaid coverage group. The QC Reviewer advises the local office when a client refuses to cooperate. The memorandum includes the information needed to complete the QC review. If the client reapplies before the QC review period ends, the Worker must not approve the benefit until the client agrees to cooperate and takes all steps necessary for the QC Reviewer to complete the review. When applicable, the Worker notifies the QC Reviewer that the individual has reapplied and wishes to cooperate in the QC review. Eligibility begins when the client completes the requirements to cooperate with QC. If the client reapplies after the QC review period expires, the benefit may be approved only if the client supplies all information previously required by QC, as well as all information needed to establish current eligibility. The QC review periods are as follows: • SNAP benefits: October through the following September • Medicaid: October through the following March; April through the following September For SNAP, if the individual reapplies after 125 days from the end of the annual review period, the client is not required to cooperate with the QC Reviewer. WV WORKS reviews are completed by the Division of Planning Quality Improvement (DPQI).