Complete a review of MA eligibility every 12 months. Every review or change in circumstances requires appropriate action and recording.
Per 42 CFR 435.916(b), when information is received regarding changes in the individual’s circumstances (CIC) that may affect eligibility, a redetermination of eligibility for MO HealthNet must be completed.
When one or more changes occur, evaluate which eligibility factors may be in question to determine whether a complete reinvestigation is necessary or whether a review of certain eligibility factors will suffice. This may include: marriage, appointment of guardian, change in living arrangements, or change in income.