Iowa Admin. Code r. 441-74.6 - Reporting changes
Current through Register Vol. 44, No. 12, December 15, 2021
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441—74.6(249A,85GA,SF446) Reporting changes.
74.6(1) Reporting requirements. As a condition of ongoing enrollment, a member shall report any of the following changes no later than ten calendar days after the change takes place:
a. The member enters a nonmedical institution, including but not limited to a penal institution.
b. The member abandons Iowa residency.
c. The member turns 65.
d. The member becomes entitled or enrolled in Medicare Part A or Part B or both.
e. A child under the age of 21 living with the member loses minimum essential coverage, if the member is the child’s parent or other caretaker relative and will claim the child as a dependent for state or federal income tax purposes.
f. The member’s countable income increases in a manner that must be reported according to the requirements of rule 441—76.15(249A).
g. The member is confirmed pregnant.
74.6(2) Untimely report. When a change is not timely reported as required by this rule, any program expenditures for care or services provided when the member was not eligible shall be considered an overpayment and be subject to recovery from the member in accordance with rule 441—75.28(249A) and 441—Chapter 11. Program expenditures may include, but are not limited to, premiums and capitation payments.
74.6(3) Effective date of change. After enrollment, changes reported during the month that affect the member’s eligibility shall be effective the first day of the next calendar month unless:
a. Timely notice of adverse action is required as specified in 441—subrule 16.3(1); or
b. The enrollment period has expired and the member is not eligible for a new enrollment period.
[ARC 1135C, IAB 10/30/13, effective 10/2/13; ARC 1698C, IAB 10/29/14, effective 1/1/15; ARC 4973C, IAB 3/11/20, effective 4/15/20]