B Renewals Submitted After Discontinuance

Program	Manual Section
All programs	MA1401B

Procedures

Use the processes below when the customer has been discontinued for failure to complete the renewal, but calls to complete the renewal or submits the completed renewal form:

Before the effective date of the discontinuance, or
Within 90 days of the discontinuance date.

1) Customer Responds Before Discontinuance Effective Date

Step	Action
1	Has a new application been approved since the disenrollment? If YES, STOP. No further action is needed when there is no gap in eligibility. If NO, continue to step 2.
2	Did the renewal cascade to and get approved for any other MA eligibility? If YES, submit a Report a Change (RAC) on the application that was discontinued for failure to complete the renewal. Enter the date the signed renewal was received as the application date. If NO, revert the renewal application from “Disenrolled” to “Back to Pending” along with any denied applications submitted after the renewal application.
3	Do you have all the proof needed to determine eligibility? If YES, STOP. Determine eligibility from the month that benefits were stopped. If NO, continue to step 4.
4	Send an RFI for the missing proof.
5	Did the customer provide all of the proof requested? If YES, continue to step 6. If NO, STOP. Discontinue the case for the appropriate reason.
6	Determine eligibility from the month that benefits stopped, using the information that the customer provided.

2) Customer Responds After Discontinuance Effective Date but Within 90 Days of Discontinuance

When a customer is discontinued for failure to comply with the renewal but submits the signed renewal form or completes a phone renewal within 90 days of the discontinuance, a new application is not needed.

When this happens, take the following steps to process the eligibility:

Step	Action
1	Has the customer already reapplied since the discontinuance? If YES, STOP. This process does not apply. Review the renewal for any changes since the last application and process as usual. If NO, continue to step 2.
2	Is this an ALTCS eligibility renewal? If YES, find the application in which the customer was discontinued for failure to complete the renewal and click the “Begin ALTCS Application” link under that application ID. Enter the date the signed renewal was received as the application date. Include prior quarter months, if applicable. Continue to step 3. If NO, submit a Report a Change (RAC) on the application that was discontinued for failure to complete the renewal. Enter the date the signed renewal was received as the application date. Include prior quarter months, if applicable. Continue to step 3.
3	Do you have all the proof needed to determine eligibility for the application months? If YES, STOP. Determine eligibility from the month that the renewal was received ongoing, as well as any PQ months. If NO, continue to step 4.
4	Send an RFI for the missing proof.
5	Did the customer provide all of the proof requested? If YES, determine eligibility from the month that the renewal was received ongoing, as well as any PQ months. If NO, deny the case for the appropriate reason.