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West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 1 Chapter 9 Client Notification

9.1 INTRODUCTION The applicant must be notified in writing of the action taken on his application, and the client must be notified in writing, and usually in advance, of any action resulting in a change in benefits. Adverse actions, other than those specified in Section 9.3, require an advance notice period before any action is effective. For Medicaid, the client may choose to receive notifications by regular post mail or electronically. If the client opts to receive his notifications electronically, he must provide his email address through WV PATH or the Federally Facilitated Marketplace (FFM, the Marketplace). The client will then receive a confirmation email alerting him to access the notification in his account within one business day. In the event a notification is undeliverable electronically, the notification must be sent by post mail within three business days. The client may change the delivery route of his notifications at any time. Form letters are available for most situations that require a notice. Printed copies of these forms are commonly referred to as “shelf documents” and are readily available in each office. These Worker-completed forms provide spaces for the required information. These letters must be prepared in duplicate, with one copy filed in the case record. Most client notification is accomplished with eligibility system letters. The eligibility system provides both system generated and Worker-requested letters. When the eligibility system automatically sends appropriate notice to the client, no additional notification is required. A history of notification letters sent to the client is stored in the eligibility system. No additional copies are required for the case record. The instructions in this chapter apply to notification letters completed by the Worker. Information specific to long-term care assistance groups (AGs) is found in Chapter 24. There are instances in which more than one action takes place simultaneously, such as approval for Medicaid and denial of Supplemental Nutrition Assistance Program (SNAP) benefits. One notification letter is sufficient in these situations provided: • The details of all actions are contained in the letter; • The one form letter used provides the client with all rights due him for all addressed issues; and • Notice requirements for each benefit are met. In addition to the client notification letter, the Worker must provide the client with calculations showing how eligibility and/or the amount of the benefit were determined. The Worker must also provide the client the opportunity to request a Pre-Hearing Conference and/or a Fair Hearing. Appendix B contains a listing of Worker-completed notification letters and the corresponding eligibility system notification letters, when available.