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A written notice is required if a change in circumstance causes:
A customer to lose eligibility;
A decrease in services;
An increase in the customer’s share of cost; or
An increase in the customer’s premium amount.
See MA1604 for information regarding written letters.
When a letter generated by HEAplus appears to be incorrect, see Procedures for Manual Letters for instructions.
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Term |
Definition |
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Change in Circumstance |
Something that happens to a person which may impact his or her Medicaid eligibility, enrollment, share of cost or premium amount, or ability to be contacted or receive mail. |
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Program |
Legal Authorities |
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All Programs except KidsCare |
42 CFR 431.210, 211 and 213 42 CFR 435.917 42 CFR 435.919 |
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KidsCare |
42 CFR 457.343 |