Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 6/29/2022

07000 >>> 07400 >>> 7421

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7421 Passive Review Responses - After being passively reviewed, the consumer is required to contact the agency (either orally or in writing) if any of the information used in the passive review needs to be updated. Reaction to this change is based on when the change occurred, when it was reported, and the type of eligibility being received.

- If the change occurred on or before the 15th of the last month of the old review period, the change is processed as a Passive Review Response.

- If the change occurred after the 15th of the last month of the old review period, the change is not considered a passive review response. It is treated like any other change that is reported outside of the review process.

To process the Passive Review Response, staff update the case with the changes and redetermine eligibility for the first unpaid month. The reported change can result in a change in coverage and/or premium. If the passive review response includes a request for medical assistance for a new individual, the change to add the individual is processed for the month of request but coverage for existing members is protected for any paid months by continuous eligibility rules. When a premium is involved, if a positive change, the change is made for the month after the month of report.

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