The CAO will conduct a case review as often as needed based on the applicant/recipient group’s situation. When an individual reports a change, the CAO will get information from him or her to decide whether the change affects the group’s eligibility for MA. 55 Pa. Code § 133.84(d)
The CAO will conduct a case review as soon as possible but no later than ten calendar days after any of the following happens:
An individual or someone acting for him or her reports a change in the person’s situation.
The CAO finds out about a change from a responsible source.
The date that a change was expected passes.
A change in rules making a review necessary.
Information is found in the Income Eligibility Verification System (IEVS) that does not match information in the record.
The receipt of medical insurance information from an insurance company or workers compensation matches in the information on IEVS.
The individual who is the payment name asks to add a member to an existing applicant/recipient group.
Note: Voter Registration Requests. See Supplemental Handbook, Chapter 980.
If an individual asks for information on registering to vote on the SAR form, the CAO will provide the voter registration form and help them in its completion, if necessary.
If a change that could affect a person’s voter registration (such as an address change) is reported at any other time, the CAO will offer the voter registration form to the people either to get them to register to vote, or to update their voter registration information.
A face-to-face interview is not required for a review of an MA budget. The CAO may conduct the review by telephone or mail.
If a reported change is not handled in a timely manner, an overpayment may result. For information on deciding whether there is an overpayment and on processing overpayments, see Supplemental Handbook Chapter, 910, Overpayment Recovery.
Updated February 14, 2012, Replacing August 14, 2008