Section 441.22.4. Review of financial eligibility, cost-sharing requirements, exemption from cost sharing, and disenrollment in the program.

         22.4(1) An eligible individual’s continued financial eligibility for the program, cost-sharing requirements, and exemption from cost sharing shall be determined on an annual basis.

         22.4(2) The administrator shall request needed information from the eligible individual’s parent or guardian for redetermination of financial eligibility, cost-sharing requirements, and exemption from cost sharing at least 30 days prior to the expiration of the eligible individual’s eligibility period. The notice requesting information needed for renewal of eligibility shall include the ending date of eligibility for services.

         22.4(3) The department shall provide a written notice of decision determining ongoing eligibility or denial within 15 calendar days of receipt of the continued financial eligibility documentation.

         22.4(4) If the signed application and verification of continuing eligibility are not received by the department by the last working day of the renewal month, the individual’s eligibility for the program shall be terminated.

         22.4(5) Reasons for disenrollment in the autism support program include:

            a.                Death of the eligible individual.

            b.               The family no longer meets one or more of the eligibility criteria outlined in rule 441—22.2(225D).

            c.                The parent or legal guardian has failed to provide information required for redetermination of eligibility.

            d.                The eligible individual has failed to access authorized services for a period of three consecutive months and has not made arrangements with the autism service provider or administrator to access authorized services.

            e.                No funds are appropriated for the autism support program.

[ ARC 1329C , IAB 2/19/14, effective 4/1/14;    ARC 2816C , IAB 11/23/16, effective 1/1/17]