Impact on Eligibility Resulting From Changes 400-28-125-45
(Revised 10/1/11 ML #3278)
View Archives
If eligibility continues, the worker must determine when the change was effective and when the change needs to be implemented.
The effective date of the change will determine if:
- The certificate needs to be updated
- Correct payment was made
- Overpayments need to be created, and
- How payments for service months not yet processed are affected
When the change affects the certificate:
- If the change is reported and verified timely and the change:
- Benefits the caretaker - the certificate will be update the month of the change
- Does not benefit the caretaker - the certificate will be updated the month after the change was reported and verified
- If the change is not timely reported and/or not verified timely, the certificate will be updated the month that the change was occurred. If this results to a benefit to the caretaker, an underpayment will not be issued. If this results in an overpayment, the overpayment must be determined.
When the change affects a payment that has already been made:
- Overpayments may occur if the change does not match what is on the current certificate.
- The eligibility worker will need to determine if and when the certificate should have been updated based on the month the change occurred.
- If the certificate should have been updated any payments made from the date the change occurred to when the certificate was actually updated are subject to overpayments.
When the change affects a payment that has not yet been made:
- The eligibility worker will need to determine if and when the certificate should have been updated as of the month the change occurred.
- If the certificate should have been updated, any payments not yet made from the date the change occurred to when the certificate was actually updated will need to be reviewed to see if any payment can be made or if no payment can be made.
- If the current certificate reflects partial information for the change that has been reported, payment can only be made based on the information that matches what is on the current certificate.
- If the current certificate does not reflect the changes that were reported and verified, payment cannot be made.
