Review Type Definitions

 

No Review – Program will not be reviewed; coverage will continue until worker determines or is notified that coverage should end. Applicant will be notified only on coverage change.

 

Passive/ExParte – Continued eligibility based on information available to agency. A letter is mailed to the applicant notifying them of information used and to notify the agency if updates are needed.

 

Pre-Populated – Form is mailed to the applicant with the information currently on file. The applicant must update and return the form for eligibility to be determined.

 

Targeted – Applicant is mailed specific information to be completed and returned for continuing eligibility to be determined.

 

Internal – Continuing eligibility is determined based on information provided by an external contact. Applicant will be notified only on discontinuance.

 

Program Review Types

No Review

Passive/Ex-Parte*

Pre-Populated

Targeted

Internal

Programs

Adoption Support Medical

Caretaker Medical

Medically Needy Pregnant Woman

Breast & Cervical Cancer

Tuberculosis

Foster Care Medical

Poverty Level 19 Newborn

Medically Needy Children

 

 

MediKan Reintegration

Poverty Level 19 Children Aged 1-18

MediKan

 

 

Presumptive Eligibility

Transitional Medical

Working Healthy

 

 

SSI Recipients

Extended Medical

 

 

 

 

Medically Needy**

 

 

 

 

Protected Medical Groups

 

 

 

 *Includes Overridden EDBC’s

**Except for Pregnant Women & Children

 

Important Information About Review Types

If the review type is Passive also as Ex-Parte Review, KEES will start at this review type but if all the criteria is not met for this review type, the review type changes to Pre-Populated. Some examples of reasons for a review to become Pre-Populated are: Self-Employment income and resources are > 85% of limit.