M-2220, Action on Changes

Revision 20-4; Effective October 1, 2020

Document all changes or agency generated change tasks received during the 12-month continuous eligibility period and process the change at renewal, except:

  • death of the certified person;
  • voluntary withdrawal;
  • receipt of health insurance;
  • moves out of Texas; or
  • change of address.

If a change of address is received, mail the person Form H0025, HHSC Application for Voter Registration. If the person contacts CBS or 2-1-1 to decline the opportunity to register to vote after receipt of Form H0025, mail Form H1350, Opportunity to Register to Vote, to the person for a signature. File Form H1350 in the case record when the person returns the form and retain the form for at least 22 months.

Follow policy in B-532, Medicaid Reinstatement for Persons Released from Texas County Jails, if a person was incarcerated in a Texas County Jail and Medicaid is suspended.

Follow Medical Programs policy in B-600, Changes, for verification and documentation requirements.

Related Policy
Registering to Vote, A-1521
Medicaid Reinstatement for Persons Released from Texas County Jail, B-532
Changes, B-600

M—2221 Returned Mail

Revision 16-4; Effective October 1, 2016

When returned mail is received, the vendor creates and assigns a Returned Mail (RTML) task to Centralized Benefit Services (CBS) staff for processing. 

Upon receipt of the RTML task, CBS staff must take the following actions: 

  1. Review the address on the returned mail, the case record, and the State Portal to determine whether the household has reported a new address. If a new address has been reported, process the address change and, if there is a Supplemental Nutrition Assistance Program (SNAP) Eligibility Determination Group (EDG), any related changes in shelter expenses.
  2. If a new address has not been reported and a forwarding address was not provided, attempt to contact the household via telephone to obtain an updated address and document the attempt. If the household provides a new address, process the address change and, if there is a SNAP EDG, any related changes in shelter expenses. Otherwise go to Step 3.
  3. If there is an individual(s) in the household who receives Retirement, Survivor's and Disability Insurance (RSDI) or Supplemental Security Income (SSI), use the State Online Query (SOLQ) to verify the household's address. Use the address in SOLQ to update the address if the address in SOLQ differs from the address on file and, if there is a SNAP EDG, explore shelter expenses.

If the address in SOLQ matches the address in the TIERS record, document in TIERS Case Comments that the SOLQ inquiry address matches the TIERS address and take no further action.

If unable to contact the individual by phone and there is not an individual(s) in the household who receives RSDI or SSI for the:

  • MTFCY EDG, go to Step 4; and
  • SNAP EDG, follow Step 5 under the process for a case that includes a SNAP EDG in B-638, Returned Mail.
  1. If unable to update the address, simultaneously send emails using the following CBS email box to:

HPO Process

  • Send an email to the Medicaid CHIP Division (MCD) Health Plan Operations (HPO) at HPO_Star_Plus@hhsc.state.tx.us . 
  • Include in the subject line Returned Mail – [last four digits of the client's case number].
  • Include the following information in the email:
    • case name;
    • case number;
    • individual’s date of birth (DOB), Social Security Number (SSN), and Medicaid individual Identification Number; and
    • date the response is needed.
  • Leave the RTML task pending. 

PAL Process

Note:

For an individual who aged out of the Unaccompanied Refugee Minor (URM) Resettlement program, contact the following agencies and individuals to determine if the agency or individual has an updated address for the former URM:

  1. The MCD HPO and DFPS PAL staff have ten calendar days to respond. It is important that staff make the request as soon as possible. The response will include either:
  • the known address on file for the individual; or
  • no known address on file for the individual.

MCD HPO responds to the CBS email mailbox (cbs_ffche-mtfcy@hhsc.state.tx.us ) and copies the original requestor with information from the plan by the tenth calendar day from when the email is sent, either confirming or denying that they have an address on file for the client. If they confirm, the response will include the address on file.

The DFPS PAL program responds to the email box (OES_FFCC@hhsc.state.tx.us ) and copies the original requestor with information from the Lead Regional PAL staff by the tenth calendar day from when the email is sent, either confirming or denying that they have an address on file for the client. If they confirm, the response will include the address on file.

Note: If the MCD HPO and DFPS PAL both respond and provide different addresses, use the address received from the MCD HPO (unless the individual has already provided an address).

  1. For cases with a SNAP EDG, if by the Form H1020 due date, the household:
  • provides the requested information, process the address change for all active EDGs, including the MTFCY EDG, and address any related changes in shelter expenses for the SNAP EDG; or
  • fails to provide the requested information, deny the SNAP EDG for failure to provide information. Send Form TF0001, Notice of Case Action, using the denial reason, "Failed to Provide Information".

For the MTFCY EDG, if by the tenth calendar day due date the HPO/PAL information:

  • is provided, use the information to update the address in the TIERS record; or
  • is not provided, use the following steps to deny the EDG(s) using the denial reason "Unable to Locate" as stated in A-2344.1, Form TF0001 Required (Adequate Notice).
    • In Change Action Mode, go to "Household Information" and select "Yes" for the question "is the worker unable to locate the household?"
    • Run eligibility.

Note: The HPO/PAL information cannot be used to verify residence for SNAP EDGs.

  1. If MCD HPO or DFPS PAL provide an updated address within 30 days of the EDG's denial due to "Unable to Locate,” reopen the EDG.

For the SNAP EDG, if the household is denied for failure to provide information and provides a correct address within the advance notice adverse action period, reopen the EDG using the original certification period and process any related changes in shelter expenses.  Please refer to the TIERS Advance Notice of Adverse Action Reference Guide in the ASK iT Knowledge Base for instructions. 

Notes:

  • If an address provided by MCD HPO or the DFPS PAL program differs from an address provided by the household, contact the household to resolve the discrepancy.
  • For SNAP EDGs, if the household provides verification of residence, but does not provide information regarding shelter expenses, re-budget eligibility without the shelter expense and notify the household, according to policy in A-631, Actions on Changes.

Related Policy

Actions on Changes, B-631
Returned Mail, B-638