Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)


Eligibility Policy - 12/16/2019

07000 >>> 07400 >>> 7420

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7421next section

7420 Agency Action on Timely Review - If the review form is timely filed and all review requirements have been met, the agency shall promptly process the review to ensure correct and timely coverage is provided. Timely processing shall be defined as follows:

1. A review form received before the 1st day of the last month of the review period shall be processed by the change processing deadline in the last month of the review period.

2. A review form received on or after the 1st day of the last month of the review period shall be processed by the change processing deadline in the month after the last month of the review period. Whenever possible, the agency, though not required, shall still attempt to process the review by the change processing deadline in the last month of the review period.

This process may result in an extended month of coverage. Any extended month of coverage provided under this process is subject to adjustment as indicated in 7410.02(2) if understated eligibility has occurred. However, in no instance shall a claim subject to recovery be created for the extended month (see 8321.02)).

3. Due to the nature of the program, all Medically Needy (MDN) reviews, regardless of when received, shall be processed by the change processing deadline in the last month of the review period. This will ensure that a new 6 month eligibility base period is properly established beginning with the month after the month the review period ends. See also 1410.01(2).
All households shall be notified of the appropriate reporting requirements upon review approval. See 7120.

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