(Revised 10/1/2011 ML #3287)
Redetermination of eligibility for this program must be done at least annually, using SFN 407, "Redetermination of Eligibility for Medicaid." A redetermination of eligibility must be completed within thirty days and the recipient notified in writing of the action taken. A redetermination must be made within thirty days after a county agency has received information indicating a possible change in eligibility status, such as a recipient enters a nursing facility.
A recipient or recipient's guardian has the same responsibility to furnish information during a redetermination as an applicant or an applicant's guardian during an application.
Functional eligibility must be re-established at the time of the annual Medicaid redetermination. A redetermination of the recipient's functional status is to be completed at the time of redetermination for Medicaid eligibility. The Home and Community Based Service case manager will complete the functional status report and inform the Economic Assistance Unit on the transmittal form. The annual functional review is completed by Home and Community Based social worker under the Targeted Case Management provision. The functional status is reported on SFN 21 under the functional assessment section.
Basic Care requires a functional assessment be completed annually. Personal care assessment is required to be updated every six months. If a redetermination and the functional assessment do not coincide, the most recent functional assessment or personal care assessment may be used as long as the assessment is not older than six months.
