PM 19-02-03-a

New Manual TextIES Phase 2 Process

Upon implementation of the Integrated Eligibility System (IES) phase 2, the process for completing a redetermination is changed.  For more information regarding processing a medical REDE go to PM 19-02-04

For AABD Cash EDGs:

(IES) Mails IL 444-1893 Medical, SNAP and Cash Redetermination Notice 60 days prior to the last day of the certification period.

(IES) Ends AABD Cash benefits the month following the last certification month if the redetermination is not marked as received and in case change or REDE mode by close of terminal entry of the last fiscal month of the approval period.Sends IL 444-0360C Notice of Decision notifying the customer TANF benefits will stop.

(CSU/FCRC) Scans redetermination forms and proofs received to the Electronic Case Management, Redetermination Interview Required queue.

(FCRC) Claims the task for processing, using electronic verifications when available.  Schedules an interview using the office scheduler in IES.

(FCRC) After the interview is conducted and all verification factors are verified, IES is updated with the new information.  The caseworker then runs eligibility and certifies the AABD Cash EDG.

Legacy Process (ACM and IPACS)

  1. A REDE of AABD Cash sheltered care cases must be conducted within the 10th month after the initial determination or last REDE of eligibility. The first REDE for an AABD Cash case appears as due on the PAL 10 months after the calendar month in which the case is approved. Subsequent REDEs are due 12 months from the last completed REDE.
  2. The first REDE appears as due on the Priority Action List (PAL) in the 9th month of the 12-month REDE cycle. The REDE is due in the 10th month of the 12-month cycle. Subsequent REDEs appear as due on the PAL in the 11th month of the 12-month REDE cycle. The REDE is due in the 12th month of the 12-month cycle.
  3. The first REDE for Nursing Home (NH), Supportive Living Facility (SLF), and Medical cases applying for or receiving Department on Aging (DoA) services with a community spouse or dependent family members who live in the community will appear as due on the February PAL, regardless of the month of approval.  Maximus, an external vendor and part of the Illinois Medicaid Redetermination Project (IMRP), will mail Form 1229A to NH and SLF customers with a community spouse or dependent family members. The eligibility of DoA waiver customers with a community spouse or dependent family members will be verified electronically. These customers will be contacted only if additional information is needed.
  4. The system sends a monthly PAL of each case identified with a factor that suggests a high probability of ineligibility or overpayment or a case due for REDE.