Section 71-5-110 - Application for medical assistance - Application for TennCare enrollment - Notice of change in application information(a) An applicant for medical assistance under this part, or a person acting in the applicant's behalf, shall file the application in a place and manner as may be designated by the department of health or the department of human services as may be designated by the governor.(b) Any application for TennCare enrollment shall include the applicant's legal place of residence in addition to the applicant's address, if the address is different from the applicant's legal place of residence or is or contains a post office box number, and a telephone number. The inability to provide a legal place of residence or telephone number due to homelessness shall not, in itself, preclude eligibility. To the extent permitted by federal law, the application of a self-employed individual for medical assistance as a part of the TennCare program shall include a copy of the individual's most recent federal income tax return or, if the individual's business is newly established, documentation deemed sufficient by the bureau of TennCare or the department of human services to project self-employment earnings pending completion of the upcoming year's income tax return.(c)(1) Unless expressly exempted by rule of the department from reporting under this section, each enrollee in and applicant for TennCare uninsured or uninsurable coverage, including a person who applies on behalf of a family member, shall notify the bureau of any material change affecting any information given to the bureau or the bureau's designee on or with the person's TennCare application. The enrollee or applicant shall be responsible for mailing documentation of any such change within thirty (30) days of any change. The bureau shall update the person's file to reflect such changes. An enrollee or applicant, including a person who applies on behalf of a family member, commits the offense of theft of services under title 39, chapter 14, who intentionally fails to so notify the bureau of any material change that would, if properly reported, result in ineligibility or an increase in the amount of any premium or cost sharing.(2) The department shall ensure that application forms for TennCare uninsured or uninsurable coverage under this part used after July 1, 2000, apprise applicants of the requirements of this chapter.Acts 1968, ch. 551, § 10; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1910; Acts 1982, ch. 730, § 10; T.C.A., § 14-23-110; Acts 1999, ch. 139, § 1; 2000, ch. 853, § 3; 2002, ch. 880, §§ 6, 15; 2004, ch. 673, § 9.