10-144-332 Me. Code R. § 2-14

Current through 2024-51, December 18, 2024

Section 144-332-2-14 - CLOSINGS AND DENIALS

Before MaineCare coverage is ended or denied, it must be determined that the individual is not eligible under any coverage group. This includes:

I. Doing a disability determination when there is information that the individual can potentially meet the disability criteria;

II. Determining medical and financial eligibility for a Waiver, Nursing Home Care, or Katie Beckett coverage groups when there is information that the individual can potentially meet these criteria;

III. Determining continuing coverage when SSI/State Supplement cash benefits end;

IV. Determining eligibility under CHIP and Maine Rx.

When individuals lose eligibility for SSI and/or State Supplement payments and a review for continued MaineCare is needed, existing information in the case record is used to determine continuing eligibility for MaineCare. If there is insufficient information in the case record to determine eligibility or a disability determination is necessary, coverage must be continued until ineligibility is determined. If a review form is necessary, it must be sent to the individual within ten days of the date SSI and/or State Supplement coverage has ended.

10-144 C.M.R. ch. 332, § 2-14