Reporting Time Frames

When a Change in Circumstance takes place that could affect eligibility, households must report the change to FSD within 10 calendar days. FSD must process the change and provide the household notification of the change within 10 days of the change affecting the case.

Below are points to consider when applying reporting timeframes and potential outcomes to eligibility.

UNTIMELY AGENCY ACTION ON CHANGE

If TMH is granted 4 to 5 months in the past and the agency does not meet the 10-10-10 rule, FSD will need to manually mail the IM-55A (1st quarterly report). Review notice queue to ensure report is not present prior to manually sending the notice. If TMH is granted 6 months, or more, in the past please seek advice of supervisor.

POINTS TO CONSIDER WHEN APPLYING REPORTING TIMEFRAMES

    1. MEDES will NOT reduce the level of coverage for prior dates (e.g., if the income was reported 2 months ago, and it will effect the child going from MHK to CHIP73, MEDES will not lower the Level of Coverage for the two months prior)
      1. Coverage is never retroactively removed, the case should be reviewed for a possible claim when reported untimely.
      2. When the level of coverage goes up due to the change (CHIP73 going to MHK) and it’s reported timely however we are delayed in entering the change, it may be necessary to review the case for CHIP refunds. This is only in the case of agency delay. If the participant reports late we effect the change as of the date reported, we will not go back and issue CHIP refunds when they failed to report timely.
    2. You should put in the date reported on the received date field of the evidence that is added/changed and then check the Extended Eligibility. You will see the coverage is not negatively impacted for the past months
    3. This might be difficult, as the proposed determination doesn’t show this, and you don’t get the extended eligibility until after finalizing the determination. You have to look at the case the next day to see the correct extended eligibility. However, MEDES will not remove the coverage for the past dates
    4. If income change results in a better level of coverage, MEDES WILL grant coverage for past dates