0430.000.00 REVIEWS AND INTERIM ACTIVITIES

0430.010.20 Pre-Closing Ex-Parte Review

If a change in circumstances results in a determination of ineligibility for SAB, ineligibility for all Medicaid/MC+ categories must be established prior to taking action to close the case. All available information should be carefully reviewed. If potential eligibility exists under another category, change the case address if necessary, and continue Medicaid under SAB while exploring the other eligibility. Action may be taken to discontinue the cash grant while not affecting the Medicaid eligibility. Once the eligibility determination is complete, transfer the recipient to the appropriate Medicaid category. Initiate action to close the case (IM-80, etc.) if no other eligibility exists.

Do not ask the claimant to provide new information that is available to the agency or to re-verify current case information. In some situations it may be necessary to obtain additional information from the client to determine eligibility in another category. Do not close while attempting to complete the new eligibility determination.