Claims
Change Reported
Income and Expenses
MA
UIB
100

What is the result of an over issuance in Food Assistance benefits? 

A Claim

100

Households are required to report income changes at this time. 

When the HH combined gross income exceed 130% of the FPL for it's HH size. 

100

Is a loan with a repayment agreement considered countable income?

No, if the client is required to pay back the loan, the income will not count

100

The maximum income guidelines changes for Medicaid on this date

Aptil 1st

100

What program provides a federal benefit of $600.00 a week?

Federal Pandemic Unemployment Compensation (FPUC)

200

The local office incorrectly computer HH income or deduction or otherwise assigned an incorrect allotment resulting in a claim? What is this called? 

Agency Error Claim

200

Any action taken by a local office that causes a HH benefits to be reduced or terminated is called this?

Adverse Action

200

Ann is completing her Food Assistance Recertification for June 2020 issuance. Ann's daughter Kayla, who is in the household, is currently employed at Taco Bell working 10 hours a week making $120.00 an hours and is paid every two weeks. Kayla is not attending school, she graduating 2 years early and received her High School Diploma on 4/18/2020. In this scenario, would Kayla's income count towards the household's total income? 

Yes, Kayla's income will count due to Kayla is no longer in school. 

200

What is the income disregard percentage for Medicaid

5%

200

What is one expense that can be paid through UIB that is countable for Food Assistance?

Child Support Expense

300

What is the time frame to establish a claim?

The last day of the quarter following the quarter in which the overpayment or trafficking incident was discovered? 

300

A client submitted a CRF on 5/20/2020 that her 19 year-old son left the house as of 4/30/2020. Since her son left her HH size is now 3. Her RRR is due 9/2020. What month will the HH size decrease to 3 in wrap up?

October. The change will not apply until recertificate because it is a change to will hurt the HH. 

300

If a HH member is disqualified from FA due to Intentional Program Violation or Fraud, does their income count towards HH total gross income? 

Yes, but it is pro-rata

300

What Medicare Savings Program can be retroactive?

SLMB eligibility starts on the date of application or up to 3 months prior to the application date for retroactive Medical Assistance

300

What screens can be used to verify FPUC received using DOLE?

Screens H5, 23 and 24. The best one to use is 23. 

400

Federal quality control is auditing a FA case that is currently closed. When receiving benefits the HH received a $500.00 over-payment. Do we create a claim? 

Yes, because the over-payment was identified through a federal or state quality control review. If it was found through a local office we would not create a claim because the HH is no longer receiving FA. 

400

A SSI/SSA cost of living adjustment increase is considered this kind of change

A mass change

400

Lewis has submitted a timely RRR for June 2020 issuance. Lewis is currently receiving SSDI of $1147 a month. Lewis declared a prescription expense of $60.00 per month, record previously was declared as $37.00 per month. What verification/s need to be provided for the new prescription amount declared? 

Client can submit proof of prescription and payment expense but it is not required due to expense has decreased or increased less than $25 since last reported. 

400

In regards to Medicaid, what could not apply to individuals such as American Indians, Alaskan Natives, and a pregnant woman and her household?

These groups of people have no co-pays. 

400

What UIB programs, including Programs under CARES Act, does the income count for Medical Assistance?

UIB, Pandemic Unemployment Assistance Payments (PUA), and Pandemic Emergency Unemployment Compensation (PEUC)

500

The maximum amount of time we have to establish a claim a claim for an IPV/fraud claim

6 years from the date the local office was notified orally or in writing, or discovered through through the normal course of business which led to over-payment.

500

When does a Notice of Adverse Action expire?

11 calendar days from the day it is issued or 15 days for HH participating in an Address Confidentiality Program

500

Is verification needed for education income and financial aid?

No, we do not need verification to determine a HH monthly income because education income and financial aid are considered exempt income

500

Client is receiving SSDI of $1070.00 and has a Medicare Part B expense of $144.60 that is deducted from income monthly. If the client were to apply for MA in January 2020 and provides all required verification when would the State begin to pay the the medicare part B?

The State would begin to pay the Medicare Part B the following month in February 2020. The state has up to 90 days to begin to pay that premium, if they do deduct that premium from the client's income, they will receive a check for the premium for the following months after application. 

500

Client called to report she is currently receiving UIOB of $200.00 every two weeks. Using DOLE was able to verify amount and see Pay Code - 3 Partial Payments with earnings above 25%. In this situation what needs to be addressed in the case? 

In this situation, UIB would need to be entered as date verified (IEVS, Hit/Today's date). Client did not state she was not working, a phone call would need to be made to clarify on current employment and possibly a collateral contact and income verification needed.