Revision 16-4; Effective October 1, 2016

 

 

 

M—2210 How to Report a Change

Revision 15-4; Effective October 1, 2015

 

Centralized Benefit Services (CBS) staff process all changes for Medicaid for Transitioning Foster Care Youth (MTFCY) recipients. MTFCY recipients can report changes:

  • online through YourTexasBenefits.com;
  • by visiting a local eligibility determination office (which will forward the change to CBS);
  • by calling 2-1-1; or
  • in writing, by mail or fax, or by completing Form H1019, Report of Change. The individual may mail or fax the change to:
    • Document Processing Center:

HHSC
P.O. Box 149024
Austin, TX 78714-9024
Toll-free fax: 1-877-447-2839

  • A local eligibility determination office (which will send the change to CBS).

 

Note: When a change is reported by telephone, staff must verify that the person speaking is the individual or an authorized representative.

An individual is continuously eligible for MTFCY for 12 months or through the month of his 21st birthday, whichever is earlier.

An individual must report the following changes:

  • an address change;
  • income, including sources of income, regular hours worked, and pay rate;
  • Modified Adjusted Gross Income (MAGI) expenses;
  • voluntary withdrawal of the individual;
  • receipt of health insurance; or
  • if the individual moves out of state.

Process all other changes, including agency-generated changes, at the next renewal.

Exception: If the individual failed to report required information at the time of the application that causes the individual to be ineligible for MTFCY, advisors must deny the benefits and send a fraud referral to the Office of the Inspector General.

 

M—2220 Action on Changes

Revision 15-4; Effective October 1, 2015

 

If an individual reports a change or the advisor receives an agency-generated change during the 12-month continuous eligibility period and has:

  • no associated Eligibility Determination Group (EDG) – document the change and handle at renewal, unless it is a change of address, the certified individual dies, a voluntary withdrawal, receipt of health insurance or the individual moves out of Texas.
  • an associated EDG – document the change and handle at renewal, unless it is a change of address, the certified individual dies, a voluntary withdrawal, receipt of health insurance or the individual moves out of Texas.
  • a change of address – mail the individual Form H0025, HHSC Application for Voter Registration, to register to vote based on the new address. If the individual contacts CBS or 2-1-1 to decline the opportunity to register to vote after receipt of Form H0025, mail Form H1350, Opportunity to Register to Vote, to the individual for a signature. File Form H1350 in the case record when the individual returns the form and retain the form for at least 22 months.

Follow Medical Programs policy in B-600, Changes, for verification and documentation requirements.

Related Policy
Registering to Vote, A-1521

 

M—2221 Returned Mail

Revision 16-4; Effective October 1, 2016

 

When returned mail is received, the vendor creates and assigns a Returned Mail (RTML) task to Centralized Benefit Services (CBS) staff for processing. 

Upon receipt of the RTML task, CBS staff must take the following actions: 

  1. Review the address on the returned mail, the case record, and the State Portal to determine whether the household has reported a new address. If a new address has been reported, process the address change and, if there is a Supplemental Nutrition Assistance Program (SNAP) Eligibility Determination Group (EDG), any related changes in shelter expenses.
  2. If a new address has not been reported and a forwarding address was not provided, attempt to contact the household via telephone to obtain an updated address and document the attempt. If the household provides a new address, process the address change and, if there is a SNAP EDG, any related changes in shelter expenses. Otherwise go to Step 3.
  3. If there is an individual(s) in the household who receives Retirement, Survivor's and Disability Insurance (RSDI) or Supplemental Security Income (SSI), use the State Online Query (SOLQ) to verify the household's address. Use the address in SOLQ to update the address if the address in SOLQ differs from the address on file and, if there is a SNAP EDG, explore shelter expenses.

If the address in SOLQ matches the address in the TIERS record, document in TIERS Case Comments that the SOLQ inquiry address matches the TIERS address and take no further action.

If unable to contact the individual by phone and there is not an individual(s) in the household who receives RSDI or SSI for the:

  • MTFCY EDG, go to Step 4; and
  • SNAP EDG, follow Step 5 under the process for a case that includes a SNAP EDG in B-638, Returned Mail.
  1. If unable to update the address, simultaneously send emails using the following CBS email box to:

HPO Process

  • Send an email to the Medicaid CHIP Division (MCD) Health Plan Operations (HPO) at HPO_Star_Plus@hhsc.state.tx.us . 
  • Include in the subject line Returned Mail – [last four digits of the client's case number].
  • Include the following information in the email:
    • case name;
    • case number;
    • individual’s date of birth (DOB), Social Security Number (SSN), and Medicaid individual Identification Number; and
    • date the response is needed.
  • Leave the RTML task pending. 

PAL Process

  • Use the link below to identify the Lead Regional PAL staff covering the region of the client's last known address.
  • Send an email to the identified Lead Regional PAL staff.
  • Include in the subject line Returned Mail -- [last four digits of the client's case number].
  • Include the following information in the email:
    • case name;
    • case number;
    • individual's DOB, SSN, and Medicaid Individual Identification Number; and
    • date the response is needed.
  • Leave the RTML task Pending.

Note:

For an individual who aged out of the Unaccompanied Refugee Minor (URM) Resettlement program, contact the following agencies and individuals to determine if the agency or individual has an updated address for the former URM:

  • The URM's former Voluntary Agency (VolAg); and
  • The two agencies in Texas that have URM programs:
    • Catholic Charities Diocese of Fort Worth
  • Catholic Charities Diocese of Galveston-Houston
  1. The MCD HPO and DFPS PAL staff have ten calendar days to respond. It is important that staff make the request as soon as possible. The response will include either:
  • the known address on file for the individual; or
  • no known address on file for the individual.

MCD HPO responds to the CBS email mailbox (cbs_ffche-mtfcy@hhsc.state.tx.us ) and copies the original requestor with information from the plan by the tenth calendar day from when the email is sent, either confirming or denying that they have an address on file for the client. If they confirm, the response will include the address on file.

The DFPS PAL program responds to the email box (OES_FFCC@hhsc.state.tx.us ) and copies the original requestor with information from the Lead Regional PAL staff by the tenth calendar day from when the email is sent, either confirming or denying that they have an address on file for the client. If they confirm, the response will include the address on file.

Note: If the MCD HPO and DFPS PAL both respond and provide different addresses, use the address received from the MCD HPO (unless the individual has already provided an address).

  1. For cases with a SNAP EDG, if by the Form H1020 due date, the household:
  • provides the requested information, process the address change for all active EDGs, including the MTFCY EDG, and address any related changes in shelter expenses for the SNAP EDG; or
  • fails to provide the requested information, deny the SNAP EDG for failure to provide information. Send Form TF0001, Notice of Case Action, using the denial reason, "Failed to Provide Information".

For the MTFCY EDG, if by the tenth calendar day due date the HPO/PAL information:

  • is provided, use the information to update the address in the TIERS record; or
  • is not provided, use the following steps to deny the EDG(s) using the denial reason "Unable to Locate" as stated in A-2344.1, Form TF0001 Required (Adequate Notice).
    • In Change Action Mode, go to "Household Information" and select "Yes" for the question "is the worker unable to locate the household?"
    • Run eligibility.

Note: The HPO/PAL information cannot be used to verify residence for SNAP EDGs.

  1. If MCD HPO or DFPS PAL provide an updated address within 30 days of the EDG's denial due to "Unable to Locate,” reopen the EDG.

For the SNAP EDG, if the household is denied for failure to provide information and provides a correct address within the advance notice adverse action period, reopen the EDG using the original certification period and process any related changes in shelter expenses.  Please refer to the TIERS Advance Notice of Adverse Action Reference Guide in the ASK iT Knowledge Base for instructions. 

Notes:

  • If an address provided by MCD HPO or the DFPS PAL program differs from an address provided by the household, contact the household to resolve the discrepancy.
  • For SNAP EDGs, if the household provides verification of residence, but does not provide information regarding shelter expenses, re-budget eligibility without the shelter expense and notify the household, according to policy in A-631, Actions on Changes.

Related Policy

Actions on Changes, B-631
Returned Mail, B-638