New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter B - Public Assistance
Article 2 - Determination of Eligibility-Categorical
Part 360 - MEDICAL ASSISTANCE
Subpart 360-2 - Application Process
Section 360-2.6 - Changes in circumstances affecting classification or eligibility

Current through Register Vol. 46, No. 39, September 25, 2024

(a) If an MA recipient's circumstances change, the social services district must take action within 30 days to:

(1) change the recipient's classification, when the change affects Federal financial participation;

(2) discontinue eligibility, when the change affects the recipient's eligibility; or

(3) provide the proper category of assistance, when the change affects the recipient's category of assistance.

(b) If a recipient's ADC, HR, SSI, or title IV-E case is discontinued, MA will be continued until the social services district determines the recipient to be ineligible for MA. The district must determine the recipient's continuing eligibility no later than the end of the calendar month following the month in which the recipient was determined ineligible for ADC, HR, SSI, or title IV-E.

(c) The social services district must provide an MA recipient with a notice on a State-prescribed form whenever a change in circumstances causes an increase or reduction in coverage and/or liability, or causes a change in the calculation of the recipient's excess income, even if the amount of the recipient's excess income is not affected. Such notice must meet the requirements of section 358-2.2 of this Title.

(d) Whenever the social services district is informed of a change in a recipient's circumstances, it must review the recipient's need for other assistance or services. The district must inform the recipient of available assistance and services, and help the recipient in obtaining them.

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