Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 4/2/2025
07400
7410 Review Form - As indicated in 7331, 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 (see 1409.01) must be returned to the agency by the last day of the last month of the review period. Reviews received outside this period will be considered late. If the review form is not received by the time the discontinuance batch runs (around the 15th of the last month of the review period), coverage will be automatically discontinued with an effective date of the last day of the last month of the review period, see 7431.
7410.01 Using an Application Form as a Review - An application form shall be used as the review in the following circumstances:
- Received within two months prior to the Review Due month.
- Received any month after the Review Due month through the current month when the Review Discontinuance Batch has not been run.
The application is used to complete the review when all members of the household are listed on the application. The application must be reviewed for consistency with the known case information. If additional information is needed to process the review, it shall be requested from the consumer, but another application form or review form is not required.
It is not necessary for the applicant to have requested coverage for all household members on the application. If individuals who are due for review, are listed on the application form, it is assumed that they wish for coverage to continue, and the form shall be used as a review for them. If the form does not include all household members, it shall be used to determine eligibility for the newly requested individual. If the Review Due date is in the past, manual action shall be taken to discontinue the remaining household members for failing to return their review.
7410.02 Continuation of Coverage Pending Completion of Review - When a review form is received by the 15th of the last month of the review period, eligibility at current levels will continue automatically until the review process is completed. If the review is received on or before the 15th of the last month of the review period, but not registered before the change 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 a review received after the 15th of the last month of the review period, or is received during the review reconsideration period following discontinuance (see 7431), the discontinuance shall be rescinded but coverage shall not be reinstated pending the completion of the review.
Due to this process, if a review received on or before the 15th of the last month of the review period is not timely processed by the agency, as defined in 7420, the current level of coverage for the individual(s) due for review may continue past the end of the review period for one or more months [extended month(s)]. The date the timely review is received, and new program eligibility will determine if those months are subject to correction, see 7432.