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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
A written notice is sent to the applicant indicating SC certification, benefit reduction, denial, or termination.
The initial notice of decision will provide information regarding total income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. used for determining participant level. It will also provide the participant with information regarding spenddown, deductible and co-payment amounts.
For reductions, denials or terminations, the notice contains reasons for the action, with any supporting regulations. It also specifies the circumstances under which SC benefits will be continued if a hearing is requested.
SC participants will be notified of an adverse action at least 10 days prior to the effective date of adverse action, except under certain circumstances.
Timely notice requirements do not apply when:
A prescription drug billing must be reversed due to an incorrect billing, and that reversal results in a benefit or service change.
A participant chooses to withdraw from the program.
A participant requests to establish a new benefit period and eligibility for the previous benefit period is terminated (5.16.11).
A person is an inmate of a Public Institution.
Death of a participant.
This page last updated in Release Number: 04-02
Release Date: 04/30/04
Effective Date: 04/30/04