157.01 Timely Notice SR 14-09, 01/14 (MAM-A)

Inform each individual of the need to review eligibility for medical assistance to be continued.

Based on household circumstances, notify individuals that they are required to participate in a regularly scheduled:

• face-to-face redetermination; or

• online or mail-in redetermination.

Face-To-Face Redetermination

The New HEIGHTS-generated CS0001, Rede Interview, is sent to individuals who are required to participate in a face-to-face redetermination/recertification and is generated by the 15th of the month prior to the month the redetermination/recertification is due

The CS0001 advises the individual:

• of the date and time of the eligibility interview;

• that the individual must call to reschedule the interview if unable to attend the appointment and the individual wishes to continue receiving benefits; and

• the effect that the individual’s failure to attend may have on the recipient’s benefits.

The CS0001 face-to-face package generated to the individual includes:

• DFA Form 775, Rental Verification Request; and

• DFA Form 756, Employment Verification.

For a face-to-face redetermination, the individual must:

• complete DFA Form 800, Application for Assistance, DFA Form 800MA, Application for Health Coverage & Help Paying Costs, or Form 800HR, New HEIGHTS-generated Application for Assistance; and

• participate in a face-to-face interview.

Online or Mail-In Redetermination

Mail-In Redetermination

The appropriate mail-in redetermination package is sent to eligible cases by the 15th of the month prior to the month the redetermination is due and includes:

• New HEIGHTS-generated CS0005, Mail-In Rede Letter;

• a postage-paid business reply envelope;

• the appropriate application as follows:

- DFA Form 771A, Nursing Facility Care Renewal, if the individual resides in a nursing facility;

- DFA Form 800PR, Renewal Application For Children’s Medicaid (CM) and Medical Coverage For Pregnant Women (MCPW), DFA Form 811R, Application: Your Rights and Responsibilities, and DFA Form TAX INFO(T), Rede Request for Tax Info, for MCPW or CM-only cases; or

- DFA Form 800R, Application for Continued Eligibility for Financial, Medical, Child Care, and Food Stamp Benefits, and DFA Form 811R, Application: Your Rights and Responsibilities, for all other cases. Cases in this category in which at least one member also receives non-nursing facility medical assistance are additionally sent the DFA Form TAX INFO(T), Rede Request for Tax Info.

Exception: QMB, QDWI, SLMB, and SLMB135 redeterminations for New Hampshire Housing Authority (NHHA) residents, or ServiceLink-assisted individuals who are applying for these programs, may continue to be submitted on DFA Form 800Q, Assisted Application For Help With Medicare Costs Through the Medicare Savings Program.

Individuals are notified in the CS0005 that by the 15th day of the last month of the redetermination period, he or she must:

• complete and return DFA Form 800R or DFA Form 800PR with all needed verifications, including the DFA Form TAX INFO(T), if required; or

• complete and return DFA Form 771A, with all needed verifications.

Online Redetermination

Recipients with NH EASY accounts who are scheduled for what would usually be considered a mail-in redetermination are eligible to complete their redetermination online.

If the NH EASY account holder’s redetermination method is “online,” the online redetermination package is generated by the 15th of the month prior to the month the redetermination is due and includes:

• New HEIGHTS-generated CS0027, Online Rede Letter; and

• a postage-paid business reply Central Scanning Unit (CSU) envelope for the recipient to provide their verifications.

Individuals are notified in the CS0027 that:

• the household must complete the online Redetermination Application and send in all needed verifications by the 15th day of the following month;

• if the household does not complete the online redetermination process and/or provide all needed verifications by the due date, it will result in a termination of benefits;

• the household may opt out of the online redetermination process and return to a mail-in redetermination process; and

• the household should contact the District Office if they have any questions.

Individuals eligible to participate in the online or mail-in redetermination process are not required to participate in a face-to-face interview. However, an interview must be granted if one is requested.

Exception: Require a face-to-face interview for individuals who do not fully complete DFA Form 800R or do not complete the online Redetermination Application, but at minimum provide their name, address, and a signature.

When verification is not sufficient or not provided in the online or mail-in redetermination process, send New HEIGHTS-generated AE0055, Proof Needed to Determine Your Assistance. If New HEIGHTS is unavailable, use paper backup DFA Form 808, Proof Needed to Determine Your Assistance.

Policy about redeterminations, and notice of redeterminations, will change under the Affordable Care Act (ACA). This policy will be updated to incorporate these changes at that time.

References: He-W 606.01, He-W 606.100-.101, He-W 636.01, He-W 644.01, He-W 684.01-.02, RSA 167:79,III(j), RSA 167:83,II(d), 42 CFR 435.916, 45 CFR 206.10, 42 USC 1397bb