706-4 Taking Actions on Responses

Any contact from the household member about the Income Match is a response.  Note any action in the case notes.  If the household member reports he is NOT ABLE to obtain verification on his own, help him.  You may contact the source of the income on his behalf.

1. When you receive a response:

A.     If you receive complete verification, adjust the current case as needed.  Give written ten-day notice of changes in eligibility.

B.      If the response indicates a need for action, decide what further action is needed.  Note this in the case notes.  An example of this might be an employer that is no longer in business.

C.     Compute and refer any over payments to ORS.

2. What to Do When There is NO Response to Requests

Income Match reports may prompt a need to verify both current and past eligibility.

A.     When The Request is about Current Eligibility

Resolve all questions about current eligibility.  If these questions are not resolved, the enrollee is no longer eligible.  Close the case with code "WM".  Give proper written ten-day notice.  Keep copies of all written requests and notes from all other attempts to verify the income.  Be sure these comply with Safeguard Rules in Section 110.

B.      When the Request Concerns ONLY Past Eligibility

Do not deny, close, hold, reduce or change CHIP benefits because you have questions about past eligibility only.  Request verification from both the client and the source of income.  Keep copies of letters and notes from all other attempts to obtain proof of the income.  Be sure these comply with Safeguard Rules in Section 103.