MA-EPD Good Cause for Nonpayment (Archive)

The Special Recovery Unit (SRU) at DHS is responsible for good cause determinations involving MA-EPD premium non-payments or late payments. The good cause decision is based on the guidelines listed in Four-Month Penalty.

Requesting Good Cause.

SRU Decision.

Good Cause Approved.

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Requesting Good Cause

Refer clients who are unable to pay the premium by the due date or wish to claim good cause to DHS SRU. SRU may be contacted either:

l  By phone at 1-800-657-3762 or (651) 296-6607.

l  The client or financial worker may submit a written request to:

DHS Special Recovery Unit,

444 Lafayette Road,

St. Paul, MN 55155-3863.

l  Fax to (651) 282-6744.

The written request should include:

l  The client’s legal name.

l  PMI number.

l  Mailing address.

l  Phone number.

l  Reason for requesting good cause.

l  Supporting documentation.

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SRU Decision

SRU will provide the client with written notice of the decision within 30 days. Clients may appeal a finding that good cause does not exist.

SRU contacts the worker by sending either or both of the following:

l  A copy of the approval letter.

l  A MAXIS email.

SRU will notify the worker of whether the premium payment is made or not.

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Good Cause Approved

Enrollees who have been granted good cause and set up a payment plan will continue to appear on the MA-EPD Overdue Premiums Report.

l  A finding of good cause does not relieve the client’s obligation to pay the premium.

l  Do not close these enrollees for late payment unless instructed to do so by DHS.

l  If the client later pays the premium in full, reinstate coverage back to the date of closure.

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