803 Notification

Effective Date:  December 1, 2009 - September 30, 2011

Previous Policy

The agency must provide all enrollees with a written notice of any action that affects their CHIP eligibility. The notice must include the following information:

1. What action the agency is taking, (i.e., approval, denial, etc.)

2. Who the action affects and any differences to how each person is affected.

3. The reason for the action.

4. The date such action is effective.

5. An explanation of the client's right to a fair hearing if he or she disagrees with the action and when continued benefits are available if the client requests a fair hearing.

6. The policy citation that supports the action.

The agency must notify the client of the action taken on an application and the action taken on an eligibility review. The agency must also send a notice to the client whenever the agency takes an action that affects the client's eligibility for CHIP. In most situations, notification must be mailed to the enrollees at least 10 days in advance of the effective date of the action.