230.05 Granite Advantage: Community Engagement Requirement 75 Day Notice Period SR 19-03, 03/19 (MAM-A)

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New Granite Advantage recipients are given at least 75 days notice before the community engagement requirement begins. The community engagement requirement begins the first of the month following 75 days after a recipient is mandatory for the community engagement requirement.

Example 1: A Granite Advantage recipient continues receiving Granite Advantage on March 1 and is mandatory for community engagement. 75 days from the date the recipient is mandatory for community engagement is May 14. Since community engagement always begins on the first of the month unless exempt, the recipient’s community engagement requirement begins on June 1.

Exception: For recipients who had Granite Advantage closed at redetermination due to not meeting the community engagement requirement and reapply and are mandatory for community engagement, the community engagement requirement will begin on the first month following reapplication if the recipient had Granite Advantage closed in the past six months but not in the past 90 days. Former recipients who reapply more than six months after having Granite Advantage closed at redetermination due to not meeting the community engagement requirement will be allowed at least 75 days notice before the community engagement requirement begins again. Former Granite Advantage recipients who reapply within 90 days of closing for failure to meet community engagement requirements will need to meet the reconsideration requirement. See 230.20 Reconsideration of Granite Advantage.

Example 2: After being given a 75-day, notice period a Granite Advantage recipient’s medical assistance case is suspended on August 1 after failing to comply with the community engagement requirement. The case closes on September 30 at the end of the redetermination month because the recipient continued to fail to meet the community engagement requirement. The recipient applies for Granite Advantage on October 15. The recipient had Granite Advantage benefits closed in the past 6 months prior to the application, therefore the recipient will not be given another 75-day notice period and unless exempt the recipient must comply with the community engagement requirement beginning on November 1, the first of the month following reapplication.

Example 3: After being given a 75-day, notice period a Granite Advantage recipient’s medical assistance case is suspended on August 1 after failing to comply with the community engagement requirement. The case closes on September 30 at the end of the redetermination month because the recipient continued to fail to meet the community engagement requirement. The recipient applies for and is determined eligible for Granite Advantage on April 1 of the following year. Since the recipient’s last closure for failure to meet the community engagement requirement was more than 6 months prior to the recipients reapplication, the recipient is entitled to a new 75 day notice period. The notice period begins on April 1 and the recipient must comply with the community engagement requirement beginning on July 1.

Granite Advantage recipients who have an exemption that ends are allowed at least 75 days notice before community engagement begins even if the formerly exempt Granite Advantage recipient also had Granite Advantage benefits closed due to failure to comply with community engagement requirement in the past 6 months.

Example: 4: After being given at least 75-day notice period a Granite Advantage recipient’s medical assistance case is suspended on August 1 after failing to comply with the community engagement requirement. The case closes on September 30 at the end of the redetermination month because the recipient continued to fail to meet the community engagement requirement. The recipient applies for Granite Advantage on October 15. The recipient also opens for NHEP on October 15 and receives an exemption from NHEP requirements. The recipient’ NHEP case closes on November 1 for reasons unrelated to Granite Advantage. The recipient is determined to be mandatory for community engagement on November 2 because the exemption from NHEP requirements is no longer valid. The recipient gets a 75 day notice period from the date the recipient is determined mandatory for community engagement even though the recipient had Granite Advantage benefits closed or suspended in the past 6 months because recipients who lose exemptions always get a 75 day notice period. The recipient’s notice period begins on November 2 and ends on January 16 of the next year. The recipient must comply with the community engagement requirement beginning on February 1 of the next year.

References: He-W 511-512, He-W 837, RSA 126-A:5,XXIII-XXVI, RSA 126-A:5-b, RSA 126-A:67, 42 CFR 435.119, Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act (SSA) [42 USC 1396a(a)(10)(A)(i)(VIII)], Section 1906 of the SSA [42 USC 1396e], Section 1937 of the SSA [42 USC 1396u-7]