10-144 C.M.R. ch. 301, § 600-FS 666-9 - Redeterminations

1. GENERAL RULE

The right to participate ends with the last day of the certification period. The Department shall provide each household a notice of expiration by the beginning of the last full month of the certification period. Benefits shall not be continued beyond the certification period unless the Department determines the household is still eligible. For the Department to make a determination that the household is ineligible, or still eligible, the household must -

A. submit a signed recertification form,

B. provide any necessary verifications, and

C. complete an interview with the following exceptions:

(1) The Department shall process all annual eligibility reviews without an interview until the earlier of December 31, 2021, or the end of the month after the month in which the public health emergency (PHE) declaration related to COVID-19 is lifted by the U.S. Secretary of Health and Human Services unless -

(a) the household requests an interview,

(b) there is unclear information on the recertification form, or

(c) the household would be determined to be ineligible based on information provided on the recertification form.

(2) Households which have no earned income and in which all adult members are elderly and/or have disabilities will not be required to complete an interview at annual eligibility review unless -

(a) there is unclear information on the recertification form, or

(b) the household would be determined to be ineligible based on information provided on the recertification form.

The Department will conduct an interview if the household requests one.

NOTE: Advance notice of adverse action is not required when benefits change from one certification period to another.

2. TIMELY REVIEW

A. The household is considered to have met the requirements of a timely review if they:

(1) file the recertification form by the 15^th day of the last month of the certification period,

(2) complete an interview, if required, by the end of the certification period, and

(3) submit necessary verifications by the later of ten calendar days of the request or the end of the certification period.

B. If the household meets the requirements of a timely review, the Department shall determine eligibility and notify the household of the Department's determination by the end of the household's current certification period. The Department shall allow eligible households to continue their normal issuance cycle in the month following the end of their current certification period.

C. If, due to the time allowed for submitting requested verification, the Department is unable to determine a household's eligibility in time for an eligible household to participate in their normal issuance cycle, the Department shall allow any eligible household to participate within five working days after the household submits the missing verification.

3. UNTIMELY REVIEW

A. The household shall lose their right to uninterrupted benefits for failure to-

(1) file the recertification form by the 15th day of the last month of the certification period,

(2) complete a scheduled interview, if required, prior to the end of the certification period, or

(3) submit requested mandatory verifications by the later of ten calendar days of the request or the end of the certification period.

B. If the household loses their right to uninterrupted benefits due to such failures but is otherwise eligible after correcting such failures, the Department shall provide benefits within the later of-

(1) 30 days after the recertification form is filed,

(2) ten days of the date the required interview is completed, or

(3) ten days of the date the required verification is provided.

C. If the household does not file the recertification form until after the end of the previous certification period, the allotment to be issued for the initial month of the new certification period shall be prorated from the date the recertification form is received, per the process at Section 555-6(2)(B).

4. DENIALS

The Department shall process denials -

A. on the last day of the current certification period if continued eligibility cannot be determined prior to that date, or the household is ineligible and no interview could be completed,

B. within 30 days after the date the recertification form was filed, when the filing is untimely, if the household is ineligible and no interview could be completed, or

C. within ten days of determining the household is ineligible, if an interview has been completed and the household fails to provide requested mandatory verifications timely.

5. VERIFICATION

A. The household must provide verification of the following -

(1) income if the source has changed or the amount has changed by more than $50 per month,

(2) allowable medical expenses which were previously unreported or which have changed by more than $25 per month,

(3) the legal obligation to pay child support, including the obligated amount, and the amount paid,

(4) utility expenses when the household requests to use the actual cost, not the utility allowance, and the amount has changed by more than $25 per month, and

(5) information which is questionable including, but not limited to, factors affecting the composition of a household and instances where documentation appears to be outdated, inaccurate, or potentially falsified.

B. Acceptable verification is not limited to any single type of document. The Department may obtain verification from the household or other sources. Whenever documentation cannot be obtained, is questionable, unclear, or is insufficient to make a determination of eligibility or benefit level, the Department shall require collateral contacts.

6. NOTICES

A. Participating households which meet the "timely review" standards listed in 666-9(2) shall be mailed an adequate notice of the Department's determination by the end of the household's current certification period.

B. Participating households which do not meet the "timely review" standards shall be mailed an adequate notice of the Department's determination within 30 days after the date the recertification form was filed.

Notes

10-144 C.M.R. ch. 301, § 600-FS 666-9