(FCRC or Pay-in Unit) Update the IRDB (see WAG 22-08-18) if the client reports a need for medical services before the eligibility update is posted to MMIS.
Update the IRDB no later than the end of the 2nd workday following the day of the request.
Example: If the client reports a medical need on Wednesday, update the IRDB no later than Friday of the same week.
The determination should be made in IES within 2 workdays of the day the bills were received in the FCRC or within 2 workdays of the day the Pay-in Spenddown Unit receives the payment report.
(System) IES automatically run eligibility monthly. Spenddown will be met if bill/receipts and payment are sufficient to meet spenddown.
(System) Takes action, after cut-off and generates Notice of End Eligibility for Medical benefits (Form 3358) to the client. The notice says that medical coverage will be ending.
Do not exceed 6 months from the month in which the action is being submitted, which will prevent the central action from taking place.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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