*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
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Effective: December 1, 2006 |
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29.05.25 - Client Cooperation with IEVS |
Archived: June 1, 2016 |
Clients must cooperate with investigation of an IEVS match by:
l Responding to the IEVS Difference Notice within 10 days.
l Providing proof to confirm or refute the match or by signing a release of information to request proof.
Do not send the IEVS Difference Notice to a client if a fraud investigator is resolving the match.
Do not delay processing if the client has made a reasonable effort to cooperate.
Note: For IEVS purposes, cooperation is signing the IEVS Difference Notice or providing the requested verification.
Close or deny MA due to disqualification for non-cooperation with IEVS for the client and any household members to whom the client deems income or assets if the client does not respond to the IEVS Difference Notice.
l Update the disqualification (DISQ) screens in MAXIS for each disqualified household member.
l Send a notice of denial or closure when ending, reducing or denying eligibility based on an IEVS match.
The client and anyone to whom the client deems are not eligible for MA until the IEVS match is resolved.
Exception: Pregnant women, auto newborns and disabled children are not disqualified if another household member does not cooperate with IEVS.
Cooperation before Effective Date of Closing
Enrollees who cooperate before the effective date of closure:
l Continue with the resolution process.
l Update the action code on the Verification Log Update based on the resolution.
Cooperation after Effective Date of Closing
Enrollees who cooperate after the effective date of closure and are not reapplying for coverage:
l Continue with the verification process.
l Do not update the Verification Log Update.
l Document as appropriate in case notes.
Enrollees who cooperate after the effective date of closure and are reapplying for coverage:
l Continue with the verification process.
l Determine eligibility based on the updated information.
l Update the Verification Log Update based on the resolution and remove the non-cooperation code.
l Document as appropriate in case notes.