Eligibility Online Manual
Purpose: This section will provide information on periodic reviews to determine continued eligibility.
Current Policy Effective Date: July 1, 2023
Date Last Reviewed: June 28, 2023
Previous Policy: August 1, 2016
POL M1403: REVIEWS
1. Eligibility Factors Must Be Periodically Reviewed
The Department will conduct ex parte renewals when eligibility can be fully verified based on reliable information available to the Department.
All household members who are age 14 or older must be run through the Workforce Services interface.
If eligibility cannot be verified by the ex parte process, a pre-populated renewal form will be mailed.
2. Clients Must Complete The Renewal Process When An Ex Parte Renewal Cannot Be Completed
Medicaid Eligibility Renewal/Review Form - Aged, Blind or Disabled Programs for Long Term care Programs, and Medicare Savings Programs.
Medicaid Renewal Form for the Family and Children's Programs
3. Social Workers Must Complete The Review Process When An Ex Parte Renewal Cannot Be Completed For a Foster Care Program
4. Clients Must Provide Verification For Reported Changes In Circumstances When The Change Cannot Be Verified Electronically
5. Periodic Reviews Are Not Required For Certain Groups
The following groups do not require periodic reviews:
Defining Requirement: 42 CFR 435.916
A Periodic Review Is Only Considered A New Application For Individuals Newly Applying For Benefits On An Exsisting Case.