zz – Obsolete

0905.025.16 MAF / MC+ Closing Review Procedures – OBSOLETE

IM-#193 December 28, 2000

Once an individual is determined eligible for MC+/Medicaid, eligibility should continue uninterrupted until the individual is determined ineligible for every category of MC+/Medicaid.  A termination without a review for on-going eligibility is improper.  Reviews for on-going eligibility must be conducted without the involvement of the recipient, if possible.  This is known as an ex parte review.  If the ex parte review does not suggest eligibility, the recipient must be given an opportunity to provide any additional information needed to establish eligibility prior to termination.