Family and Children's Medicaid MA-3410 TERMINATIONS, DELETIONS AND EX PARTES
IV. REQUIREMENTS FOR EX PARTE MIC/NCHC re-enrollment
A. Conduct an ex parte review for re-enrollments of eligibility for both MIC and NCHC programs for children under the age of 19. Use the Case Management Report to identify MIC/NCHC cases due for re-enrollment.
1. The recipient is not required to complete a re-enrollment form.
2. The Case Management Report includes MIC and NCHC cases due for review three (3) months prior to the end of the certification.
3. The ex parte review date begins the first day of the 11th month of the current certification period. Do not react to changes in income that occur after the first day of the 11th month of the current certification period, unless the assistance unit was ineligible based on income verified in the ex parte process. Document the change in the case record for verification at the next review.
B. Review the case file to determine if any changes have been reported.
C. Review On-line verifications (OLV).
D. See III.E. above for verification requests.
E. Verifications of income cannot be used from the last re-enrollment of case being reviewed.
F. The DMA-5075, Verification Checklist for MIC/NCHC Re-enrollments is the base document for the ex parte re-enrollment. Document all verifications on this form. File the completed DMA-5075 in the case record.
G. If ongoing eligibility is established, authorize for the next certification period in the correct aid program category.
H. If the entire case or individuals in the case are ineligible for ongoing assistance in any aid program/category, including NC Health Choice, document the record and send a timely notice to terminate Medicaid/ NCHC.
REVISED 10/01/11 - CHANGE NOTICE 13-11