2120 Cooperation

2120 Cooperation

The client must cooperate with all program requirements. In addition, the client shall cooperate with the agency in the establishment of eligibility including providing necessary information, reporting changes, as required, cooperating in the application process, cooperating in quality assurance reviews, and cooperating in obtaining resources.

2121 Supplying Information

The client (or ineligible caretaker) shall supply information essential to the establishment of eligibility; give written permission on prescribed forms for release of information regarding resources when needed; and report changes in circumstances in accordance with 9121 as appropriate.

2122 Application and Review Process

To determine eligibility, the application form must be completed and signed, and certain information on the application must be verified. If denied or terminated for refusal to cooperate, the client may reapply but shall not be determined eligible until he or she cooperates.

The client shall also be determined ineligible if he or she refuses to cooperate in any subsequent review of its eligibility, including reviews generated by reported changes and recertification. For medical, the formal review requirement does not apply to pregnant women and children under the age of 1 who have continuous eligibility under the Medicaid program or are eligible under the SI program.  In instances where a pre-populated review is sent for an individual with a passive review type, return of the review is not a requirement for the individual with the passive review type.  

2123

Reserved

2124 Potential Resources

The agency shall provide education to clients regarding potential resources that they may be entitled to and encourage the client to obtain access to those resources. With exception, the client may not be found ineligible solely for failure to pursue potential resources, as noted below.

1. The client is required to pursue coverage through Medicare when determined eligible; see 2911.2.
2. The client is required to pursue recovery of non-exempt transferred assets; see 5723 and subsections.
3. Client shall identify and provide information to assist the agency in pursuing any third party who may be liable to pay for medical services under the medical programs.

2124.1 Requirements

The client is required to take any necessary action to acquire certain potential resources; see 2124.  In many instances, legal action may be necessary. In general, any source must be considered. It is the responsibility of the client to demonstrate all required actions have been taken to make the resource available. The special situations listed below are applicable:

1. The client must cooperate with the Medical Subrogation Unit as well as cooperate with the requirements of the Health Insurance Premium Payment System (HIPPS) including enrollment in the employer health insurance plan if cost effective; see 2912.   
2. Reserved  
3. MediKan applicants shall be required to pursue SSA/SSI benefits as a condition of eligibility; see 2181. In addition, individuals may not be rendered ineligible for a disability determination referral for failure to apply for SSI benefits unless qualifying for MediKan per 2181.
4. Recipients who are, or have been, married are expected to fully pursue any spousal elective share rights when the current or former spouse dies. Under Kansas law, a spouse is entitled to a portion of the augmented estate (generally any estate less the homestead). If all resources do not properly pass onto the surviving spouse at the time death, the surviving spouse may file a probate claim to obtain the allowed spousal share. Failure to pursue any spousal elective share rights shall result in ineligibility. 

   The surviving spouse must file for his/her elective share within 6 months of the date of death to protect a claim.  For purposes of this section, the surviving spouse must provide verification within 60 days of the date of death that he/she has either filed a claim or is taking positive action to file a claim.  If timely verification is not provided, eligibility may be denied or discontinued.  If timely verification is provided, the agency shall continue to monitor the case until the claim has been fully adjudicated by the court.

   Legal staff in the Estate Recovery Unit (ERU) are available to assist with technical details regarding potential actions. All cases involving potential spousal elective share issues shall be referred to ERU.  When spousal rights have been forfeited a transfer of property penalty may be applied; see 5422.

   For additional guidance, see Policy Memo 2002-12-03, Spousal Elective Share and Policy Memo 2018-07-01, Spousal Elective Share Filing Requirement.

2124.2 Failure to Comply

Failure to meet these requirements without good cause shall: 

1. Reserved
2. Render the client ineligible for assistance. However, minor children will not be impacted by a caretaker's failure to meet these requirements on behalf of himself or the minor.

If the client is cooperating in obtaining the identified potential resource, assistance shall continue.