Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)


Eligibility Policy - 12/16/2019

07000 >>> 07300 >>> 7330 >>> 7330.02

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7330.03next section

7330.02 Passive Review - A Passive Review is a review where information known to the agency is used to make a new eligibility determination. . Eligibility is redetermined and reauthorized without worker involvement. The member receives notification outlining the information used for the redetermination. The member is required to inform the agency of any changes or incorrect information used in the determination. If the recipient has no changes to report, the review process is complete. If the recipient contacts the agency (either orally or in writing) with updated information based on receipt of the review notification, action is taken to update the case.

In order to qualify for a passive review, when earned income exists it must meet reasonable compatibility under the automated RC test completed by KEES. In addition, each of the following program types may be subject to a passive review when specific criteria are met:

- Medically Needy (MN) – There is no earned income (including self-employment), countable resources are less than 85% of the limit, there is no trust and there are no due and owing medical expenses.

- Caretaker Medical, TransMed and Extended Medical – Earned income is reasonably compatible, there is no self-employment, and individuals do not move to a Protected Medical Group, Working Healthy, Medically Needy, or MSP.

- Poverty Level Pregnant Woman (Medicaid) – Fails the super passive criteria, passes the income test, passes reasonable compatibility, and does not contain self-employment income.

- Poverty Level Pregnant Woman (CHIP) – Income does not exceed 200% of the FPL, income is reasonably compatible, and does not contain self-employment income.

- Poverty Level Newborns and Children (Medicaid and CHIP) – Income does not exceed 200% of the FPL, income is reasonably compatible, and does not contain self-employment income.

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