B    Change Reporting

Policy

Customers or their representatives are required to report any changes that may affect their MA eligibility, premium amount or share of cost.  The types of changes that must be reported are described in MA1502.  However, anyone who knows about a change in the customer’s circumstances may report the change.  Changes are most commonly reported by:

·        Customer;

·        Customer’s representative;

·        Customer’s spouse;

·        Customer’s relatives, friends or neighbors;

·        AHCCCS Complete Care (ACC) plan or program contractors;

·        Medical facilities and providers;

·        Attorneys; and

·        Trustees.

NOTE          Information reported by someone other than the customer or the customer’s spouse or representative must be confirmed before any action can be taken.  The customer or customer’s representative must confirm the change report is correct, or other proof must be received, even if the change would not normally need proof.  For example, a neighbor reports that the customer moved out of state.  This must be confirmed before taking any action as the neighbor may not have accurate information.

1)    How Can Changes be Reported?

Changes can be reported:

·        Online through Health-e-Arizona Plus (HEAplus);

·        By phone;

·        By fax;

·        In writing; or

·        In person.

2)    How is the Customer Informed?

The customer is informed about their responsibility to report changes in a variety of ways, including:

·        On each approval letter or change letter;

·        On the AHCCCS Medical Assistance program application;

·        For ALTCS only, verbally during an interview and in writing with the Rights and Responsibilities of Customers (DE-113); or

·        Verbally during assistance with an in-person application.

Definitions

Proof

The type of proof needed depends on the type of change.  See MA1502 for types of changes and proof needed.

Timeframes

In general, changes must be reported as soon as the future event becomes known.  However, there are different timeframes for some changes.  See MA1502 for types of changes and timeframe requirements.

NOTE          Special reporting requirements apply to trustees of Special Treatment Trusts.  Trustee reporting requirements are described in MA803.A.14.

Legal Authority