The following examples illustrate the new review reconsideration period policy as discussed in section D(1) of the memo.
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1 ATTACHMENT A Policy Memo The following examples illustrate the new review reconsideration period policy as discussed in section D(1) of the memo. Note: Odd-numbered examples illustrate MAGI examples and even-numbered examples illustrate non-magi examples. Review Form Example 1: A CHIP recipient with a 05/2014 review fails to return the review form by 05/31/2014 (the end of the current review period). The program automatically closes effective 05/31/2014 for failure to complete the review process. The review form is ultimately returned on 09/06/2014. Since the review form was received outside of the three (3) month reconsideration period (06/01/2014 through 08/31/2014), the form is treated like a new application and may not be processed as a review. assigned beginning with the first month of eligibility (the date the review is actually processed). Example 2: A QMB-only recipient with a 06/2014 review fails to return the review form by 06/30/2014 (the end of the current review period). The program automatically closes effective 06/30/2014 for failure to complete the review process. The review form is ultimately returned by 09/30/2014 (the last day of the reconsideration period). Since the review form was returned within the three (3) month reconsideration period, the review is processed. effective 07/01/2014 through 06/30/2015. Requested Information Example 3: A T19 recipient with a 07/2014 review returns the review form timely on 07/10/2014. Needing additional information to complete the review, a request for information is sent on 07/15/2014 with a due date of 07/25/2014. The requested information is not received by 07/25/2014, so coverage ends on 07/31/2014. On 09/19/2014, the requested information is provided. Since the requested information was returned within the three (3) month reconsideration period (08/01/2014 through 10/31/2014), the review is processed. assigned effective 08/01/2014 through 07/31/
2 Example 4: A Medically Needy (MN) recipient with a 06/2014 review fails to return the form by 06/30/2014 (the end of the current review period). The program automatically closes effective 06/30/2014 for failure to complete the review process. The review form is ultimately returned on 08/11/2014. Since the review was received within the three (3) month reconsideration period (07/01/2014 through 09/30/2014), the review is processed. sent on 09/02/2014 with a due date of 09/12/2014. The requested information is not provided by 09/12/2014, so the review is denied on 09/18/2014. The requested information is finally provided on 10/07/2014. Since the requested information has been provided in an untimely manner outside of the three (3) month reconsideration period, the review is still denied. A new application is required. No review period assigned as the review has been denied. Example 5: A CHIP child is determined eligible for ongoing coverage 07/ /2015 based on a Passive Review. On , the family calls to report the income was not correct, as the mother went back to work in There is no information on the interface to verify the employment so information is requested from the mother. It is not provided and the case is closed effective On the information is provided and the child is still eligible for CHIP, but his premium increases from $20 to $50. Because information was returned within the reconsideration period, coverage is back dated to begin August 1, 2014, with the $50 premium. The new review period is still 07/ /2015. Example 6: A nursing home recipient with a 08/2014 review fails to return the review form by 08/31/2014 (the end of the current review period). The program automatically closes effective 08/31/2014 for failure to complete the review process. The review form is ultimately returned on 11/21/2014. Since the review form was returned within the three (3) month reconsideration period (09/01/2014 through 11/30/2014), the review is initially processed. However, additional information is needed to complete the review and a request for information is sent on 11/25/2014 with a due date of 12/05/2014. The requested information is provided on 12/04/2014. Since the requested information is timely provided (even though outside of the three (3) month reconsideration period), the review is processed. effective 09/01/2014 through 08/31/2015. Example 7: A T19 recipient with a 10/2014 review fails to return the review form by 10/31/2014 (the end of the current review period). The program automatically closes effective 10/31/2014 for failure to complete the review process. The review form is 2
3 returned on 01/21/2015. Since the review form was returned within the three (3) month reconsideration period (11/01/2014 through 01/31/2015), the review is processed. Needing additional information to complete the review, a request for information is sent on 01/27/2015 with a due date of 02/06/2015. The requested information is not provided by 02/06/2015 and the review is denied on 02/10/2015. The requested information is eventually provided on 02/26/2015. Since the requested information is untimely provided outside of the reconsideration period, but within 45 days from the date the review form was received, the review is processed. assigned effective 11/01/2014 through 10/31/2015. New Information Example 8: An HCBS recipient with a 09/2014 review returns the review form and all requested information in a timely manner. Due to excess resources, the review is denied and eligibility ends effective 09/30/2014 (the last day of the current review period). On 12/01/2014, information is provided verifying that resources are now within the allowable limit. Since this additional information was provided within the three (3) month reconsideration period (10/01/2014 through 12/31/2014), the review is processed based on the new information. If eligible, coverage would be effective 10/01/2014. effective 10/01/2014 through 09/30/2015. Example 9: A CHIP recipient with a 04/2014 review returns the review form and all requested information in a timely manner. Due to excess income, the review is denied and eligibility ends effective 04/30/2014 (the last day of the current review period). On 06/23/2014, a change in tax filing status is reported. Since this information was provided within the three (3) month reconsideration period (05/01/2014 through 07/31/2014), the review may be reinstated and processed based on the new information. If eligible, coverage would be effective 05/01/2014. assigned effective 05/01/2014 through 04/30/2015 Coverage Start Date Example 10: A QMB-only recipient with a 07/2014 review fails to return the review form by 07/31/2014 (the end of the current review period). The program automatically closes effective 07/31/2014 for failure to complete the review process. The review and all required information are returned on 09/12/2014. Since the review form and information are returned within the three (3) month reconsideration period (08/01/2014 through 10/31/2014), the review is processed. If eligible, QMB coverage would be effective 3
4 08/01/2014 with no break in assistance. effective 08/01/2014 through 07/31/2015. Example 11: A CHIP recipient with a 05/2014 review fails to return the review form by 05/31/2014 (the end of the current review period). The program automatically closes effective 05/31/2014 for failure to complete the review process. The review form is returned on 08/29/2014. No additional information is requested. Since the review form is received within the three (3) month reconsideration period (06/01/2014 through 08/31/2014), the review is processed. In this case, the child continues to be eligible for CHIP with a premium of $30/month. CHIP coverage with a $30 premium is effective 06/01/2014 with no break in assistance. A twelve (12) month review and CE period would be assigned effective 06/01/2014 through 05/31/2015. Example 12: A QMB-only recipient with a 10/2014 review fails to return the review form by 10/31/2014 (the end of the current review period). The program automatically closes effective 10/31/2014 for failure to complete the review process. The review form is ultimately returned on 01/26/2015. Since the review form was received within the three (3) month reconsideration period (11/01/2014 through 01/31/2015), the review is processed. sent on 01/30/2015 with a due date of 02/02/2015. The requested information was not provided by 02/02/2015, so the review is denied on 02/05/2015. The requested information is finally provided on 03/09/2015. Since the information was untimely provided outside of the three (3) month reconsideration period, but within the 45 day reactivation period (45 days from the date the review form was received), the review may be processed. If eligible, QMB coverage would be effective the month after the month the review is actually processed. There would be a break in assistance. beginning with the first month of eligibility (the month after the month the review is actually processed). Example 13: A family with both a CHIP and Medicaid child fail to return a review form for The case closes at the end of the month. The form is actually returned on 12/29/2014. Since the review form was received within the three (3) month reconsideration period (10/01/2014 through 12/31/2014), the review is processed. sent on 01/05/2015 with a due date of 01/15/2015. The requested information is not provided by 01/15/2015, so the review is denied on 01/20/2015. The requested information is finally provided on 02/12/2015 and the coverage is 4
5 processed on Since the information was untimely provided outside of the three (3) month reconsideration period, but within the 45 day reactivation period (45 days from the date the review from was received), the request is processed. When processed, the CHIP child continues to receive CHIP and the Medicaid child continues to receive Medicaid. Because of the timing of the application and information, CHIP coverage begins the date the case is approved, Medicaid coverage begins back to the beginning of the reconsideration period, or 10/01/2014. The Medicaid child s CE date is set to match the CHIP child so the review period and CE dates for both children end
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