1. (1) When an HSD Medical Program beneficiary or an individual authorized to act on the beneficiary’s behalf reports a change that may affect eligibility, the Agency shall promptly redetermine eligibility before reducing or ending medical benefits.
2. (2) The Agency may send an RFI to request additional information or verification related to the reported change.
3. (3) If a beneficiary remains eligible as a result of a redetermination due to a reported change, a new 12-month eligibility period is not established; the original renewal date is maintained.
4. (4) If the Authority has information about anticipated changes in a beneficiary’s circumstances that may affect eligibility, it shall redetermine eligibility at the appropriate time based on the changes.

Statutory/Other Authority

ORS 411.402, 411.404, 413.042 & 414.534

Statutes/Other Implemented

ORS 411.400, 411.402, 411.404, 411.406, 411.439, 411.443, 413.032, 413.038, 414.025, 414.231, 414.447, 414.534, 414.536 & 414.706

History

DMAP 23-2020, amend filed 05/07/2020, effective 05/08/2020
DMAP 24-2016, f. & cert. ef. 6-2-16
DMAP 78-2015(Temp), f. & cert. ef. 12-22-15 thru 6-18-16
DMAP 3-2015, f. & cert. ef. 1-30-15
DMAP 67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15
DMAP 20-2014, f. & cert. ef. 3-28-14
DMAP 4-2014(Temp), f. & cert. ef. 1-15-14 thru 3-30-14
DMAP 54-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14