Eligibility Online Manual

M1403 Reviews


Purpose: This section will provide information on periodic reviews to determine continued eligibility.


Current Policy Effective Date: August 1, 2016

Date Last Reviewed: August 1, 2016

Previous Policy: January 1, 2014

POL M1403: REVIEWS

1. Eligibility Factors Must Be Periodically Reviewed

2. Clients Must Complete Appropriate Renewal Form

    • Medicaid Eligibility Renewal/Review Form - Aged, Blind or Disabled Programs for Long Term care Programs, and Medicare Savings Programs.

    • Medicaid Renewal for the Family and Children's Programs

3. Social Workers Must Complete Appropriate Review Form

    • Foster Care

4. Clients Must Provide Verification For Reported Changes In Circumstances

5. Periodic Reviews Are Not Required For Certain Groups

The following groups do not require periodic reviews:

    • Pregnant women program, unless the client is within the 60 days post-partum period

    • SSI recipients

    • Subsidized Adoption

Reference:

Defining Requirement: 42 CFR 435.916

Clarifying Information:

A Periodic Review Is Only Considered A New Application For Individuals Newly Applying For Benefits In An Exsisting Case.

Worker Responsibilities: