Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 5/18/2022

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1320 Simplified Eligibility - The applicant is the primary source of information used by the agency for purposes of determining eligibility. For some factors of eligibility, additional information will have to be obtained. The agency shall use, to the greatest extent possible, the information on the application/redetermination as provided by the individual applicant/recipient, for purposes of determining eligibility and extent of entitlement.

1320.01 - Carefully review the application for completeness, clarity, consistency, and lack of error or questionable statement.

1320.02 - Consider additional information from agency records.

1320.03 - Advise the applicant/recipient when it is necessary for the agency to go to other sources, and when necessary obtain his consent on the information release form. If he does not consent to the necessary contacts, it may not be possible to determine that initial or continuing eligibility exists. Each applicant and recipient gives consent to a full field investigation when he signs the application/redetermination form, but a signed informational release form may be necessary to obtain the needed information. See 1211.04.

1320.04 - Give the applicant/recipient the opportunity to present additional clarification when information on the form is incomplete, unclear, or inconsistent, or where other circumstances in the particular case indicate to a prudent person that further inquiry needs to be made. Negative action as a result of failure to provide the information can be taken only when written notice was given allowing at least 12 calendar days from the date the notice is initiated to return the information.

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