In my previous blog I discussed what to do when NJ seeks to terminate your Medicaid long-term care benefits when the COVID-19 emergency ends. In this blog, I will discuss how NJ will conduct renewals for continuing Medicaid eligibility.
Under existing Federal law, NJ must renew eligibility once every 12 months for beneficiaries. The renewals for continuing Medicaid eligibility are mandatory.
NJ must begin the renewal process by first attempting to redetermine eligibility based on reliable information available to the agency without requiring information from the individual (ex parte renewal).
- If available information is sufficient to determine continued eligibility without requiring information from the individual, the state agency (DMAS) that renews eligibility on an ex-parte basis must notify the beneficiary that their coverage has been renewed.
- If available information is insufficient to determine continued eligibility, the DMAS must send a renewal form and requests additional information from the beneficiary.
In establishing renewal procedures, New Jersey must take into account the time needed for:
- Completing the renewal prior to the end of a beneficiary’s eligibility period.
- Direct existing beneficiaries to return their renewal form and submit required documentation, if appropriate, to continue their Medicaid eligibility.
The agency must then verify information returned by the beneficiary and notify the beneficiary of its determination and offer additional time to evaluate eligibility if the beneficiary returns information late in the renewal process.
To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Medicaid Attorney