Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 101 - Coverage Groups and Processing Applications and Reviews Redetermination Processes
Chapter 12 - The Redetermination or Renewal Process
Rule 23-101-12.3 - Administrative Renewals

Universal Citation: MS Code of Rules 23-101-12.3

Current through September 24, 2024

A. A renewal of eligibility is processed without requiring information from the beneficiary if the Division of Medicaid is able to do so based on reliable information contained in the beneficiary's case record and other more current information available to the Division of Medicaid, such as data secured from data matches with other state, federal and commercial databases as required by the Affordable Care Act (ACA).

B. If a beneficiary's eligibility can be renewed administratively, based on available information, the recipient will be notified of the approval and the basis for the approval.

C. The beneficiary must inform the Division of Medicaid, through any of the modes permitted for submission of applications listed in Miss. Admin. Code Part 101, Rule 4.2, if any information reported in the renewal process is inaccurate. The individual is not required to sign and return the approval notice if all information on the notice is accurate.

D. Administrative reviews are not processed for age, blind and disabled (ABD) cases with an asset test.

E. If an administrative review does not result in an approval in the same program, Medicaid or the Children's Health Insurance Program (CHIP), then it is not possible to complete the administrative review. A pre-populated renewal form is issued to allow the beneficiary to provide current information.

42 C.F.R. § 435.916; Miss. Code Ann. § 43-13-115.

Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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