<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.18.05.04" title_num="10" subtitle_num="18" chapter_num="05" heading="Changes in Eligibility and Disenrollment.">
  <paragraph num="A.">
    <text>A recipient shall notify the Department within 10 business days of a change in:</text>
    <paragraph num="(1)">
      <text>Availability of third-party payment for services covered under MADAP;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Gross household income; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Address.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If a change reported in §A of this regulation results in a recipient no longer qualifying for MADAP, the Department shall:</text>
    <paragraph num="(1)">
      <text>Determine the recipient ineligible for MADAP; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Disenroll the recipient.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The notice of intended action, which notifies the recipient of the disenrollment, shall:</text>
    <paragraph num="(1)">
      <text>Be mailed to the recipient at least 15 business days before the effective date of disenrollment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Include an explanation of the action;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Cite the regulation supporting the action; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Explain the right of the recipient to request reconsideration or an appeal of the decision.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>If the recipient is determined to be ineligible before the next verification of eligibility is due to be submitted to the Department because of a change in eligibility, the disenrollment shall be the earlier of:</text>
    <paragraph num="(1)">
      <text>The date on which the recipient’s next verification of eligibility is due to be submitted to the Department; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The first day of the month that is at least 15 calendar days after the date of the notice of ineligibility for MADAP benefits.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>If the recipient’s Medical Assistance coverage is pending or active, the recipient shall be disenrolled, as determined by the Department.</text>
  </paragraph>
</regulation>