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10.6.3 Redetermination Processing Standards

ISSUE DATE: 04/2018

See Chapter 10.6 (Redetermination process) for general information about the redetermination process.

See Chapter 7.1 (Verification due dates) for information about due dates when additional verifications are requested at redetermination.

See Chapter 10.6.6 (Redetermination processing – Reinstatement) for information about reinstating cases when the redetermination is received after the case closes.

Frequency of redeterminations

Eligibility cannot be determined more frequently than every 12 months. System functionality prohibits workers from reprocessing eligibility using redetermination standards once the redetermination is processed. When the redetermination is not completed before the redetermination due date, MEC2 will issue a closing notice for failure to complete the redetermination

Evaluate returned redetermination form and required eligibility verifications

Review the returned redetermination form and required eligibility verifications to determine if the redetermination is complete.

  • · If the redetermination is incomplete, send the family a MEC2 Special Letter: Verification Request requesting missing information and/or verifications.
  • · If the redetermination is complete, use the information provided on the redetermination form and verifications submitted to determine the current:
  • - Family composition and household size
  • - Family status and reporting type
  • - Annualized income and allowed deductions
  • - Authorized activity for any parent in the family
  • - Child care needs
  • In MEC2, update case data windows in the redetermination biweekly period even if changes happened earlier in the 12 month eligibility period.

    In most cases, do not reconcile what happened in the past 12 months. Changes that were not required to be reported until redetermination are considered timely if reported at redetermination. See Chapter 8.3 (Reporting requirements) for information about the reporting types and requirements.

    If you have information that indicates a family did not report a required change timely but the information reported on the redetermination indicates family is currently eligible, process the redetermination and reconcile the previous 12 month eligibility as a separate process to determine if an overpayment needs to be established. See Chapter 14 (Overpayments).

    Redetermination requirements

    When additional verifications are requested at redetermination, use the MEC2 Special Letter: Verification Request. See Chapter 7.1 (Verification due dates) for information on determining the due date of the Special Letter.

    If the redetermination form and all required eligibility verifications are received by the last day of the redetermination period, determine whether the family is eligible for continued child care assistance:

  • · If the family is eligible, notify the family and provider of any changes to the number of hours of care authorized or changes to the copayment amount. See Chapter 12.3 (Notices to families) and Chapter 12.6 (Notice to providers).
  • · If the family is not eligible, send the family and provider a 15 calendar day notice before terminating benefits. The adverse action notice may need to be sent more than 15 calendar days before terminating benefits to ensure the family receives at least 12 months of CCAP. See Chapter 12.3.12 (Termination notices – Family) and Chapter 12.6.9 (Termination notices – Provider).
  • · If schedule verifications are missing but all other required information has been returned prior to the end of the redetermination period and the family remains eligible, the redetermination should be processed but care should not be authorized.
  • - If the Service Authorization(s) has not already been closed, end the service authorization using the reason code “care no longer authorized” using the last day of the redetermination period as the end date and approve service authorization to end allowing for a 15 day notice. Suspend the family’s case for a period up to one year. See Chapter 8.9 (Suspending a case).
  • - If the Service Authorization(s) were closed due to incomplete redetermination and the case is being reinstated, end the service authorization using the reason code “care no longer authorized” using the date the redetermination is processed as the end date and approve service authorization to end allowing for a 15 day notice. Suspend the family’s case for a period up to one year. See Chapter 8.9 (Suspending a case).
  • - Child care can be authorized when the schedule verifications have been submitted. Child care can be authorized retroactively back to the date care was ended or six months prior to the date the service authorization is issued, whichever is later (assuming that the schedule provided applies to the time period when care was ended). See Chapter 9.3 (Payments to providers).
  • If the redetermination form and all required eligibility verifications are not received and processed by the last day of the redetermination period, eligibility must end. MEC² will send a 15 calendar day notice of termination to the family and provider at the end of the family’s redetermination period if the redetermination process is not completed. See Chapter 12.3.12 (Termination notices – Family) and Chapter 12.6.9 (Termination notices – Provider).

    If a complete redetermination form and all required verifications are received within 30 days after the case closes, see Chapter 10.6.6 (Redetermination processing – Reinstatement).

    Example – Redetermination period processing cycle

    February 28: MEC2 nightly batch job identifies families whose redetermination due date on the Redetermination Window is in 45 days, on April 15. MEC2 sends the Redetermination Cover Letter and Redetermination Packet. MEC2 sends a notice to each provider a family uses that the family’s redetermination is due.

    March 31: Due date listed on the Redetermination Cover Letter for the family to return their completed redetermination form and required verifications.

    April 15: MEC2 identifies families whose Redetermination Window is not in Approved Status or “Updates Required” status. For identified cases, MEC2 sends the 15 calendar day notices to terminate benefits to the family and their providers.

    April 30: For any families not in Approved Status or “Updates Required” status, the family’s case is terminated.

    May 30: Last day the family can turn in a complete redetermination form and all required eligibility verifications to have their case reinstated.

    Legal authority

    Minnesota Statutes 119B.025
    Minnesota Rules 3400.0180
    Minnesota Rules 3400.0040

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