Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 101 - Coverage Groups and Processing Applications and Reviews Redetermination Processes
Chapter 13 - Special Case Reviews
Rule 23-101-13.1 - Conducting a Special Case Review
Universal Citation: MS Code of Rules 23-101-13.1
Current through September 24, 2024
A. A special case review is completed when changes occur between regular reviews which may result in adjustments to eligibility or benefit level.
B. A special case review is not a full review.
1. The special case or an individual
is evaluated to consider the impact of the changed information.
2. Factors unrelated to the change are not
re-verified as part of a special case review.
C. A special case review of eligibility is required when:
1. The beneficiary reports a
change in circumstances which could affect eligibility and benefit level,
2. Information is received from
any other source which could affect eligibility and benefit level, and/or
3. Potential changes in
eligibility are indicated by information available to the Division of Medicaid.
D. The special case review process may result in termination of benefits, benefit reduction or adjustments to Medicaid income. It may also involve procedural changes, including, but not limited to, updating or correcting case information with no impact on eligibility or benefits.
42 C.F.R. § 435.916; Miss. Code Ann. § 43-13-121.
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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