Iowa Admin. Code r. 441-74.6

Current through Register Vol. 47, No. 11, December 11, 2024

Rule 441-74.6 - Reporting changes

(1)Reporting requirements. In addition to the reporting requirements in 441-Chapter 76, as a condition of ongoing enrollment, a member shall report any of the following changes no later than ten calendar days after the change takes place:

a. The member enters a nonmedical institution, including but not limited to a penal institution.

b. The member abandons Iowa residency.

c. The member turns 65.

d. The member becomes entitled to or enrolled in Medicare Part A or Part B or both.

e. A child under the age of 21 living with the member loses minimum essential coverage if the member is the child's parent or caretaker and will claim the child as a dependent for state or federal income tax purposes.

f. The member is pregnant.

(2)Untimely report. When a change is not timely reported as required by this rule, any program expenditures for care or services provided when the member was not eligible shall be considered an overpayment and be subject to recovery from the member in accordance with 441-Chapters 75 and 11. Program expenditures may include, but are not limited to, premiums and capitation payments.

(3)Effective date of change. After enrollment, changes reported during the month that affect the member's eligibility shall be effective the first day of the next calendar month unless:

a. Timely notice of adverse action is required as specified in 441-subrule 16.3(1); or

b. The enrollment period has expired and the member is not eligible for a new enrollment period.

Iowa Admin. Code r. 441-74.6

ARC 1135C, IAB 10/30/2013, effective 10/2/2013

Amended by IAB October 29, 2014/Volume XXXVII, Number 9, effective 1/1/2015

Amended by IAB March 11, 2020/Volume XLII, Number 19, effective 4/15/2020

Amended by IAB March 8, 2023/Volume XLV, Number 18, effective 5/1/2023