PM 19-02-02-b
IES Phase 2 Process
Upon implementation of the Integrated Eligibility System (IES) phase 2, the process for completing a redetermination is changed. The REDE process is described in PM 19-02-04.
Legacy Process
Updated with Policy Memo Changes to the Illinois Medicaid Redetermination Project (IMRP) Revised
Updated with Policy Memo Update to the Illinois Medicaid Redetermination Project (IMRP) for SSI and Medical Extension Cases
Updated with Medical Morsel Medical Morsel Non-Cooperation with the Illinois Medicaid Redetermination Project (IMRP) - REVISED
Never ask a person who receives only medical benefits to come to the FCRC to complete a REDE.
A medical redetermination form is centrally sent to clients who are not authorized SNAP benefits on the Assist case through the IMRP process.
For reviews completed other than the yearly REDE, Form 643 is not required. Document in the record how the REDE was completed.
If additional information is needed from the customer, send Form IL444-1721 Instructions to Client or the IMRP Information Request Notice. Allow the client 10 days to return the information. If the client requests additional time to provide the information, follow the same procedures as for an initial application in PM 02-07-02b. An extension can also be granted in an unusual situation which makes it difficult for the client to cooperate within the 10 days. Send Form 1721 to document the information still needed and the new due date. Document the extension in the case record. If requested information is not provided, cancel medical assistance for anyone to whom the missing information applies. Do not cancel medical assistance for a child under age 1 covered under Moms & Babies. If proof of income deductions or medical expenses is not provided, do not allow the deduction. If the case is ineligible without the deduction or expense, cancel the medical assistance.
Always review TPL information at each REDE and complete Health Insurance Report (Form 1442), if necessary. Send Change in Case/Non-Custodial Parent Status (Form 493) to the appropriate DCSE Regional Office if information is received during the REDE process that relates to child support.
Complete:
- an AWVS clearance and enter the SSN on Form 552 for each person in the benefit unit whose SSN was obtained during the REDE process and (the SSN) does not appear on Form 552;
- an AWVS clearance on all known multiple SSNs not listed on Form 552, for each person for whom benefits are requested or received;
- an AWVS clearance for each legally responsible relative (RR) in the home who is not included in the benefit unit and whose SSN is known;
- a clearance of the immigration status of noncitizens through SAVE if the immigration status is subject to change or proof was not previously obtained;
- an SoS residency clearance for the payee and all adult requestors (unless verified through another acceptable source);
- an SSA citizenship inquiry for each person for whom citizenship and identity has not yet been documented.
Complete authorization, reporting, and case record documents:
- Code the EDD in Item 60 for any person in the unit who is pregnant. Include the 4-digit date of expected delivery.
- Complete Parent/All Kids Assist Computation Sheet (Form 2383A) and attach to Form 643.
- Initiate Form 157/157C if cancellation is indicated. See WAG 01-06-03 "Notices of Change" and follow established procedures. Form 157 must identify the reason for the action being taken and cite the applicable policy.
- Complete Notice of Change in Medical Benefits (Form 2434A) if the case status changes from Regular to Spenddown.
Immediately file REDE forms, verifications, and Form 643 in the case record. Document in the case record that the REDE was completed and any changes made.
At REDE for a case with a child who has an absent parent:
- provide Form 1759 to the client and
- update Item 63 on Form 552.
NOTE: When Item 63 on Form 552 is coded with 19, 20, 21, 22, 24, 30, 31, or 32 for the absent parent, an automatic referral is made to DCSE for child support services. If a corresponding child support case is not found for the child, an interview with DCSE is automatically scheduled for the caretaker relative.
The system sends Notice Regarding Continuation of Child Support Services (Form 2659) to the caretaker relative when assistance is canceled and child support services are continued. This form explains the rights and responsibilities of the caretaker relative and the services that continue.
All 94R cases and cases in spenddown status are excluded from referral for CSE services. These excluded cases are notified of the availability of CSE services by a centrally issued brochure Child Support Enforcement Program (Form 1759).
