Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 4/26/2024
07000 >>> 07300 >>> 7330 >>> 7330.02
7330.01
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. When unearned, countable income from Social Security (SSA) exists, it must be within $5.00 of the amount found on the SSA data source. In addition, each of the following program types may be subject to a passive review when specific criteria are met:
- Medically Needy (MDN) – There is no earned income, countable resources are less than 85% of the limit, there is no trust and there are no due and owing medical expenses, and the status of the Spenddown is ‘met.’
- Caretaker Medical (CTM), TransMed (TMD) and Extended Medical (EXT) – Earned income is reasonably compatible, there is no self-employment, no individuals outside the home are claimed as tax dependents, there is no discrepancy in the tax information for the household member(s) due for review, and individuals do not move to a Protected Medical Group, Working Healthy, Medically Needy, or MSP program.
- Poverty Level Pregnant Woman (PLN/PW) – Fails the super passive criteria, passes the income test, and passes reasonable compatibility.
- Poverty Level Pregnant Woman Under 19 (PLT or 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.