Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 12/9/2022

07000 >>> 07100 >>> 7140

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7140 Processing Reported Changes - When the agency receives information that a change has occurred, the eligibility worker shall act on the change within 10 days after the date the change is reported by taking the following actions:

(1) Document in the case file the reported change, the date the change occurred, and the date the change was reported;

(2) Determine if verification or additional information is required;

(3) Contact the household to request needed information or verification as soon as possible;

(4) Changes are effective the month following the month of the change, given timely and adequate notice requirements, with the exception of income changes that are reported at the time of a request to add a new individual.

(a) Households reporting changes which would result in a change in benefits must provide any required verification within 12 days of the date of agency request. No change in benefits shall be granted if the household does not provide the required verification. If no verification is required or if the verification required is received within 12 days from the date of verification request, the change in benefits are to be granted effective the month following the month the change is reported. If the verification is received after 12 days from the date the verification was requested, the change benefits would be effective the first month following the month the verification is received.

(b) Changes resulting in ineligibility or a decrease in benefits shall effect eligibility the first month possible considering timely notice requirements.

(c) When processing an income change along with a request to add coverage for a new individual, the new income must be verified and used in the month of request. This allows the income to be used in the determination for the new person and is also applicable to the rest of the household members in that month. This could result in a change in coverage or the reduction or removal of a premium obligation in the month of report when applicable.

(5) If an automated system action occurred on the case prior to a worker becoming aware of the change, the worker must evaluate the effect of the change to determine if any incorrect payment occurred as result.

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