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Effective: December 1, 2007 |
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20.30.10 - MA/GAMC Income Changes |
Changes must be reported following policy found in Income Changes and the policy in this section for MA and GAMC.
See Adding a Household Member for information on when to add the income of a person who moves into an existing household.
See Spenddowns for more information on what to do when changes in income create or change a spenddown amount.
Income Changes - MA and GAMC Renewals.
Income Changes - Between Renewals - GAMC.
Unearned Income Changes - Between Renewals - MA.
Earned Income Changes - Between Renewals - MA.
Income Changes - MA and GAMC Renewals
Verify and act on all income changes reported at renewal.
Income Changes - Between Renewals - GAMC
Clients must report changes in income within 10 days of the change.
l Act on the change immediately.
l Provide 10-day notice of any negative actions.
l Verification of an income change is not required.
l Document changes in case notes.
Unearned Income Changes - Between Renewals - MA
Clients must report changes in unearned income within 10 days of the change.
l Act on the change immediately.
l Provide 10-day notice of any negative actions.
l Verification of an income change is not required.
l Document changes in case notes.
Earned Income Changes - Between Renewals - MA
Clients must report changes in earned income within 10 days of the change.
l Act on all reported changes in income, including receipt of a lump sum, immediately.
l Do not require verification of changes in earned income reported between renewals.
l Determine if the income change creates or changes a spenddown.
n Do not change the spenddown type.
n For monthly spenddowns recalculate beginning with the month the change occurred.
n For six-month spenddowns recalculate the spenddown for the certification period.
n Update the necessary changes in satisfaction date and spenddown amount.
n Notify the household that they should contact providers to bill or rebill MA due to a decrease in the spenddown.
l Claims that were not denied will be reprocessed automatically by MMIS.
l Claims for services on the satisfaction date will be automatically reprocessed.
l Document the specifics of the income change in the case record. Explain the income calculation completed as a result of the reported change.
Example:
Bridget receives MA for herself and her two children. Their current certification period is June - November. The household’s only income is child support for the children. All household members are eligible without a spenddown. On September 5, Bridget reports that she began a job on September 1.
Action:
Re-determine eligibility for each household member for the current certification period.
n Bridget: For June through August, count $0 income for Bridget. The children’s child support is not deemed to her. For September through November, project anticipated earnings.
n The children: For June through November, count child support for each child who receives it. For September through November, add Bridget’s projected net earnings for each child.
Determine whether the household members are eligible for TYMA and whether anyone in the household has a spenddown.
Example:
Delbert receives MA with a six-month spenddown. His current certification period is January - June. He met his spenddown on January 14 with a large hospitalization bill from early January. On April 9, Delbert reports his work hours had been cut in half.
Action:
The worker must recalculate the spenddown for the entire certification period. The decrease in income results in a decreased spenddown amount and an earlier satisfaction date. The worker must update MMIS with the new data, and send a notice to Delbert to have his providers bill MA for more of his hospital bill to be paid.