PM 18-05-07-b

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new textFirst Quarterly Review

  1. IES generates the first HFS 3361 at cut off in the 3rd month of the 12 month medical extension certification period, which is due back by the 15th of the following month (the 4th month in the cert period). The 3361 instructs the client to return the form to the Central Scan Unit.
  2. The client returns the form to Central Scan Unit or FCRC.
    1. When Form 3361 is received at the Central Scan Unit or FCRC, a worker must enter the date in the "4 Month Quarterly Report Date" received date field on the "REDE Received - Details" page. This lets IES know that the 3361 form has been received and prevents auto-cancellation.
    2. The FCRC worker must review the form and enter any updated information into Data Collection as a case change. If the client continues to qualify for extended medical, no further action is taken.
    3. If the reported income is over 185% of the FPL, or the client has quit their job without good cause, the adults no longer qualify for extended medical. If the persons is not eligible under another medical program, the system cancels medical benefits effective the 7th month of the cert period.
  3. If the client does not return the form, IES automatically cancels the adults' medical benefits effective the 7th month of the cert period.

new textSecond Quarterly Review

  1. IES generates the first HFS 3361 at cut off in the 6th month of the 12 month medical extension certification period, which is due back by the 15th of the following month (the 7th month in the cert period). HFS 3361 instructs client to return form to the Central Scan Unit.
  2. The client returns the form to Central Scan Unit or FCRC.
    1. When Form 3361 is received at the Central Scan Unit or FCRC, a worker must enter the date in the "8 Month Quarterly Report Date" received date field on the "REDE Received - Details" page.
      Note: The title of this field will be corrected to "7 Month Quarterly Report Date" after Phase 2 implementation.
    2. The FCRC worker must review the form and enter updated information if any, into Data Collection as a case change. If the client continues to qualify for extended medical, no further action is taken.
    3. If the reported income is over 185% of the FPL, or the client has quit their job without good cause, the adults no longer qualify for extended medical. IES determines eligibility for another program, and cancels medical benefits if not eligible effective the 8th month of the cert period.
  3. If the 2nd quarterly review form is not returned, IES will not automatically cancel the adults' medical benefits. The worker must take an action to close the extended medical EDG. If another action is processed on the case after the due date, IES will close the medical extension EDG if a received date has not yet been entered.

Example: Ms. Rose and her 5 year old son, Joe, qualify for extended medical due to increased earnings. Their 12 month cert period is from July through the following June. Their first review form is mailed in mid-September with a due date of Oct 15th. If not received, Ms. Rose's ME eligibility will automatically end effective January (the 7th month of her ME cert period). Joe will continue to receive medical until the end of the cert period.

Her 2nd review form will be mailed in mid-December. If not received by the due date, the worker takes action to end her ME eligibility effective February, or the next month that can be affected.

new textWhen Form 3361 is Not Generated

Form HFS 3361 is not generated in the 3rd and 6th months of the ME certification period in the following situations:

  • At conversion, when a Medical Extension case that is past the 3rd or 6th month of it's certification period is converted from the CDB to IES at Phase 2 implementation.
  • Ongoing, when the Medical Extension is certified after the date that a 3361 review form should have been generated because an income change was not reported or budgeted timely.

When a Medical Extension EDG is certified in IES too late to issue the quarterly review form, IES will bypass the 1st (or 2nd) quarterly review. The missed review form will not be sent to the client and IES will exempt the person from that review by populating the received date. The worker is not required to generate the 3361 manually.

Example: Mr. Laurel is certified into ME effective February due to earnings that increased in September. Since his 12 month certification period should have started last October, it is too late to generate the first 3361 that should have been issued in December. IES automatically populates a receipt date in the "4 Month Quarterly Report Date" field to prevent an auto cancellation. The next quarterly review form will be generated in mid-March, which is the 6th month of the certification period.

new textIncome Change on Medical Extension with SNAP

For Medical Extension, since verification is not required when an income change is entered in IES, the worker must select 'other acceptable verification' to prevent generating a VCL for medical.

If the case contains SNAP, a VCL for SNAP only may be required. See PM 18-04-09-a for income changes reported on cases not in MPR and for income changes reported during the approval period for those cases in MPR. For cases in MPR when the change is also reported on the report form see, PM 19-07-07 and WAG 19-07-07.