9330 Client Requirements for Timeliness

9331 Application - Review Form - As indicated in 9320, households subject to a pre-populated review shall be given a minimum of 30 days to return a required review form.  The review form shall be mailed to the individual on or about the 15th of the next to last month of the review period.  To be considered timely received, the signed review form must be returned to the agency by the 15th of the last month of the review period.  If the review form is not received before the closure processing deadline, coverage will be automatically discontinued with an effective date of the last day of the last month of the review period (see 9350). 

9332 Continuance of Coverage Pending Completion of Review - When a review form is timely received (see 9331) and registered before the closure processing deadline, eligibility at current levels will continue automatically until the review process is completed.  If the review is timely received, but not registered before the closure processing deadline, coverage will be automatically discontinued.  In that instance, the discontinuance shall be rescinded, and coverage reinstated while the review is pending.  Note that if an untimely review is received during the review reconsideration period (see 9350), the discontinuance shall be rescinded but coverage shall not be reinstated pending the completion of the review.

Due to this process, if a timely received review is not timely processed by the agency, as defined in 9340, the current level of coverage for the household may continue past the end of the review period for one or more months [extended month(s)].  The date the timely review is received will determine if those months are subject to correction.

1. If the review is received before the 1st day of the last month of the review period, it is anticipated that the review will be completed prior to the closure processing deadline in the last month of the review period (see 9340).  Therefore, there should be no extended months of coverage.  However, if the review is not processed timely, resulting in extended coverage month(s), those months are subject to correction, if necessary.  Understated eligibility shall be restored, and an agency error claim shall be created for any overstated eligibility (see 11120) for those month(s). 

2. If the review is received on or after the 1st day of the last month of the review period, correction is required beginning with the second extended month.  The first extended month is only subject to correction when the new benefit level is greater than the previous coverage.  In that instance, the first extended month shall be corrected to reflect the new benefit level for that month.  If the new benefit level is less than the previous coverage, no correction of the first extended month is required.  Correction is required for all months beginning with the second extended month. 

Note:  If the review is not timely processed, as noted above, eligibility will continue at the current level until some intervening action, automated or manual, is taken to either change or discontinue coverage.  If the ultimate action taken on the case is adverse, timely and adequate notice of the action is required (see 1431). 

9333 Information/Verification -  Information/Verification - All information and/or verification shall be provided by the requested date. Clients must submit any required verification or additional information within 12-days from the date of the initial request in order to ensure the rights to uninterrupted benefits, provided the deadline to submit such verification does not occur prior to the date the application was timely filed.

Follow the verification requirements at initial application, 1322, except that citizenship, non-citizen status, providing an SSN, residency, and identity, do not have to be reverified unless a change has been reported or it is questionable.  

1. For Passive and Super-Passive Reviews:   No additional verification is required to complete the review process unless the household reports a change.

2.  For Non-Passive/Pre-Populated Reviews:  The verification requirements for initial applications are applicable except for the following:

a. Citizenship, non-citizen status, providing an SSN, residency, and identity – do not reverify unless a change has been reported or the information is questionable.

b. Resources - Resources need not be reverified if the following requirements have been met:

i. An application (other than a MIPPA application) or pre-populated review form was filed within the last 12 months;

ii. Resources were verified within the last 12 months;

iii. The reported value of all countable resources does not exceed 85% of the applicable resource limit;

iv. There is no indication from either internal or external sources that there has been a change in resources, such as a resource no longer exists, there is a new resource, or a potential or actual transfer has occurred; and

v. There are no resources that are being monitored for continued exempt status, including countable resources with no market value, resources that are exempt due to a legal impediment, real property that is exempt due to a bona fide effort to sell, real property that is unavailable because sale of the property would cause loss of housing for a joint owner, and resources that are exempt for a specified period of time, such as a retroactive SSA/SSI payment for 9 months.

vi. In addition, this policy does not apply and reverification of resources at review is required when there is a trust (countable or exempt), there is countable life insurance, and/or there is a community spouse.

vii. If all resources have been verified within the last 3 months (i.e.: current month plus the last two months), the 85% countable resource threshold does not apply.  Instead, as long as countable resources are within the allowable resource limit, and all other policy criteria described above are met, reverification of resources is not required.

viii. If the requirements of this policy are met, the self-attested value of liquid resources provided from the consumer and the previously verified value of all other resources shall be used.

If the above conditions have not been met, reverification of all resources is required.  The standard verification process for an initial application applies.  Except, verification of bank accounts [excluding Direct Express accounts – see 1322.1(9)(c)] for pre-populated reviews that fail to meet the policy requirements described above shall be requested through the electronic Asset Verification Solution (AVS).  Verification of the bank account(s) shall be formally requested from the recipient at the same time the AVS request is completed.  If the AVS response verifies the bank account, that amount shall be budgeted on the case.  Otherwise, the verification received from the recipient based on the agency request shall be used.

Note:  When applying the 85% countable resource threshold, income known to be deposited into a countable financial account shall first be deducted from that account in determining the countable resource value.