Assistance may be suspended for individuals who are temporarily not eligible. Action to suspend payment must follow the advance notice requirements of 1431.
Suspension of medical benefits does not shorten an established medical eligibility base period and a new application is not required to reinstate assistance within the period. Regardless of the procedure used, medical eligibility shall not be suspended without meeting notice requirements related to adverse action. Benefits shall not be suspended for more than 6 months except in rare cases where there is clear documentation that circumstances have changed so that medical eligibility can reasonably be expected within the next 6 month period. If the case is not to be closed, medical eligibility on a medical only case will be suspended. See 1414.1 (2).
Medical assistance can be reinstated in the month following the month of closure or suspension if the reason for the closure has been cured by the end of the month following the month of closure/suspension and all other eligibility requirements are met. The exception to this is if medical assistance was discontinued due to whereabouts unknown (see 9124). If the individual was discontinued due to whereabouts unknown and confirmation of whereabouts is received prior to the end of the review period, coverage shall be reinstated back to the date of termination, unless there is a reported change in circumstances that will impact eligibility. Information that becomes known to the agency must be acted upon in accordance with 1323. For continuation of benefits pending the outcome of an appeal, see 1612.
A new application is not required for reinstatement purposes unless the current review has expired. However, if coverage was closed for failure to provide or failure to return the review form and the information is returned within the three-month reconsideration period (see 9350), the form can be used to redetermine eligibility.
Case closures will always be effective the last day of a given month. To protect credibility with medical providers, the termination date may not be changed after issuance of a medical coverage. However, the date of death will be used for a deceased individual since there are no eligible services after that date.