105.03 Eligibility Reviews (MAM)

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Individuals must cooperate with any subsequent eligibility reviews, including reviews necessary due to reported changes or quality control processes.

If individuals fail to cooperate with eligibility reviews, send a notice of termination informing the individual that their assistance will end unless they cooperate with the review. If they indicate a willingness to cooperate during the advance notice period, notify the reviewer of the response and reinstate assistance when the individual cooperates.

. If any assistance group member refuses to cooperate with a quality control review of medical assistance, terminate medical assistance for the assistance group. Provide an Advance Notice Period. The period of ineligibility continues until the earlier of:

- The individual's compliance with the quality control review requirements; or

- The end of the federal reporting period during which the quality control review was conducted.

. When the period of ineligibility has expired, the assistance group must reapply for assistance.