171 EXTENDED MEDICAL ASSISTANCE DUE TO EMPLOYMENT SR 06-12, 10/06 (FAM-A)

All individuals who were members of a NHEP/FAP/UP financial or categorically needy medical assistance group may receive up to 12 months of extended medical assistance without completing a new application, if the assistance group becomes ineligible for financial or categorically needy medical assistance and meets the criteria noted under the appropriate heading below

For Financial Assistance Cases:

• ineligibility for financial assistance is due to new or increased earnings of the parent/caretaker relative included, or

• ineligibility for NHEP/FAP/UP is due to an increase in the number of hours the principal wage earner is employed.

For Categorically Needy Medical Assistance Cases:

• ineligibility for categorically needy medical assistance is due to new or increased earnings of the parent/caretaker relative included, or ineligibility for NHEP/FAP/UP is due to an increase in the number of hours the recipient is employed, and

• the assistance group has received NHEP/FAP/UP financial or categorically needy medical assistance during any 3 of the 6 months prior to the month in which the categorically needy medical assistance case closed.

The reason for the termination of NHEP/FAP/UP financial or categorically needy medical assistance must be the employment-related reasons listed above. Extend medical assistance only if there are no changes in program criteria, nonfinancial criteria, or resources that make the assistance group ineligible at the same time as the employment-related change.

Exception: An individual who is determined by a court to have fraudulently received NHEP/FAP/UP financial or categorically needy medical assistance in any of the 6 months immediately preceding the closing of a financial or categorically needy medical assistance case due to employment related reasons is not eligible for extended medical assistance. Other assistance group members are also ineligible for extended medical assistance. The penalty stays with each individual from the original assistance group whether they remain in the same assistance group or move to another assistance group. If a penalized individual moves into another assistance group, the new assistance group is not penalized—only the original penalized individual.