A How to Complete a Response Required Renewal for ALTCS

A Response Required Renewals

Program	Manual Section
All programs	MA1401A

Procedures

1) Determining if a signature is needed for a renewal (Non-ALTCS)

When processing a Response Required Renewal for Medical Assistance (MA), take the following steps to determine if a signed renewal application is needed.

NOTE Regardless of the instructions in this procedure, all inconsistent or questionable information that could cause ineligibility must be resolved before approving the renewal.

Step	Action
1	Did the hubs or other agency sources find resources or income that would make the customer ineligible? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to step 2.
2	Has the customer provided information about new income that is not verified by the hubs or other agency sources? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to step 3.
3	Update any new income verified by the hubs or the case file.
4	Check the following sources to see if the proof needed to renew the customer’s eligibility is on file: The case file; Proof in the case file that the income amount does not change; Current payment list or amount confirmation for Railroad Retirement benefits or Indian gaming payments; and Published VA or US OPM COLA income increases to calculate the customer’s new payment (only when there is proof on file of a previous payment amount).
5	Is all proof needed to renew eligibility already available in the file or from other sources? If YES, STOP. Process the renewal. Add a case note stating “Renewal pended for verification. Proof was found in the file or data sources for pending factors and eligibility can be renewed with information available. A signature is not required from the customer.” If NO, a signed renewal application is needed. See MA1402 and Section 3 below to help the customer get needed proof.

2) Determining if a signature is needed for a renewal (ALTCS).

When processing a renewal application for a Response-Required renewal for ALTCS, take the following steps to determine if a signed renewal application is needed.

NOTE Regardless of the instructions in this procedure, all inconsistent or questionable information that could cause ineligibility must be resolved before approving the renewal.

Step	Action
1	Is this the first renewal for a community spouse case that changes initial rules to post initial rules? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to step 2.
2	Review DocuWare for trust documents. Does the customer have a trust? If YES, Continue to step 3. If NO, skip to Step 4.
3	Is the trust funded? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to step 4.
4	Did the hubs, Asset Verification System (AVS), or other agency sources find resources or income that would make the customer ineligible for ALTCS? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to Step 5.
5	Has the customer provided information about new income or resources that are not verified by the hubs, AVS, or other agency sources? If YES, STOP. A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get proof. If NO, continue to Step 6.
6	Add any new resources found by AVS that are not currently in HEAplus. Update any new income verified by the hubs or the case file.
7	Check the following sources to see if the proof needed to renew the customer’s eligibility is on file: The case file; Proof in the case file that the income amount or resource value does not change; AVS: See MAP705N.6 to determine if an ad-hoc request is needed when financial accounts are not verified by AVS; Current payment list or amount confirmation for Railroad Retirement benefits or Indian gaming payments; and Published VA or US OPM COLA income increases to calculate the customer’s new payment (only when there is proof on file of a previous payment amount).
8	Is all proof needed to renew eligibility already available in the file or from other sources? If YES, STOP. Process the renewal. Add a case note stating “Renewal pended for verification. Proof was found in the file or data sources for pending factors and eligibility can be renewed with information available. A signature is not required from the customer.” If NO, A signed renewal application is needed. See MA1402 and Section 3 below to help the customer get needed proof.

3) Helping the customer get proof for a renewal

When the renewal requires a signature, take the following steps for each income or resource that needs proof.

Step	Action
1	Call the company or payor associated with the income or resource. Was the information able to be verified? If YES, STOP. Verify the factor and process the case. If NO, continue to step 2. NOTE When possible, make collateral contacts to get proof. Some factors, like terminated income, may have been verified before. Check case notes and documents provided for earlier applications.
2	Is there a valid Authorization to Release Information (DE-200) on file? If YES, skip to step 6. If NO, continue to step 3.
3	Send a Request for Information (RFI) to the customer for all proof needed. Make sure the RFI includes a DE-200 for the customer to sign.
4	Did the customer return the verifications needed to complete the renewal by the RFI due date? If YES, STOP. Verify the factors and process the case. If NO, continue to step 5.
5	Did the customer return the signed DE-200 by the RFI due date? If YES, continue to step 6. If NO, STOP. Discontinue the customer for failure to provide proof.
6	Use Google to search for the company associated with each pending income or resource. Were you able to find the website for the company? If YES, continue to step 7. If NO, STOP. Take the following action: If an RFI has not been sent for the renewal, send an RFI for the proof needed. Return to step 4. If an RFI was already sent for the proof needed, discontinue the customer for failure to provide proof.
7	Determine if there is an email address or fax number that can be used to get proof of the income or resource. Is there an email or fax that can be used? If YES, continue to step 8. If NO, STOP. Take the following action: If an RFI has not been sent for the renewal, send an RFI for the proof needed. Return to step 4. If an RFI was already sent for the proof needed, discontinue the customer for failure to provide proof.
8	Search the forms library for the appropriate form that can be used to verify the income or resource. (For example, to verify unearned income, use the Request for Verification of Unearned Income (DE-207) form).
9	Save a copy of the form to a secure network location, such as the “K:” drive.
10	Fill in as many of the fields as possible on the verification form.
11	Send the pre-filled verification form AND the signed DE-200 form to the email address or fax number that was identified in step 7. Wait 7 calendar days for a response to the verification request.
12	Was the verification form completed and returned? If YES, verify the factor in HEAplus and process the case. If NO, take the following action: If an RFI has not been sent for the renewal, send an RFI for the proof needed. Return to step 4. If an RFI was already sent for the proof needed, discontinue the customer for failure to provide proof.