Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1712.1 - ELIGIBILITY RE-DETERMINATIONS
Section 17-1712.1-4 - Redetermination due to a change in beneficiary household circumstances
Universal Citation: HI Admin Rules 17-1712.1-4
Current through February, 2024
(a) Between annual redeterminations of eligibility, an individual or household shall report any changes in circumstance that may affect eligibility through their elected mode of communication within ten days of the change.
(b) Upon receipt of the change in circumstance information, the department shall redetermine eligibility according to the provisions of sections 17-1712.1-2 or 17-1712.1-3, as applicable.
(c) For an individual determined eligible using MAGI-based methodology, the department shall:
(1) Limit requests for additional information
solely to the reported change in circumstance;
(2) If able to redetermine eligibility of all
requirements based on the reported change, a new twelve-month period of
eligibility may be established;
(3)
If informed of an anticipated change, redetermine eligibility at the
appropriate time of the change;
(4)
Process the addition of a new member to the household in accordance with
paragraphs (b) and (c) of this section; and
(5) Prior to making a determination of
ineligibility, determine all bases of eligibility under other chapters under
this subtitle; and
(6) For an
individual determined ineligible for Medicaid, the department shall transfer
the individual's application information for other insurance affordability
programs as appropriate pursuant to
42
CFR
§435.1200(e).
(d) For an individual determined eligible using MAGI-excepted methodology, the department:
(1) May utilize the change in circumstance
opportunity to collect additional information in order to complete a
redetermination of eligibility for the household. Requests for non-applicant
information shall be limited as described under section
17-1711.1-21(e);
(2) May establish
a new twelve month period of eligibility if able to redetermine eligibility of
all requirements;
(3) Except for
the addition of a newborn to a household, shall require a beneficiary
requesting the addition of a new household to submit a completed application
and supporting documentation as described in chapter 17-1711.1. A
redetermination of eligibility for the household shall be completed based upon
the submitted application and information;
(4) If informed of an anticipated change,
shall redetermine eligibility at the appropriate time of the change;
(5) Prior to making a determination of
ineligibility, shall determine all bases of eligibility under other chapters of
this subtitle; and
(6) For an
individual determined ineligible for Medicaid, the department shall transfer
the individual's application information for other insurance affordability
programs as appropriate pursuant to
42
CFR
§435.1200(e).
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