10.18.05.03

.03 Application and Enrollment.

A. Application.

(1) Applicant.

(a) An applicant shall submit a completed application to the Department on the form designated by the Department that includes:

(i) Responses to all applicable questions; and

(ii) Supporting documentation related to residency, medical, and financial eligibility criteria.

(b) An applicant may voluntarily withdraw the application at any time without prejudice.

(c) An applicant may submit a new application at any time.

(2) The Department shall:

(a) Approve the application if the:

(i) Application is complete; and

(ii) Applicant is determined to be eligible;

(b) Disapprove the application if the:

(i) Application is incomplete;

(ii) Applicant fails to provide sufficient information or documentation to determine eligibility; or

(iii) Applicant provides the appropriate documentation but is determined ineligible; and

(c) Provide the applicant with written notice of the final disposition of the application.

B. Enrollment.

(1) A recipient shall:

(a) Attest to continuing eligibility every 6 months:

(i) In writing; or

(ii) By telephone; and

(b) If the Department requests it, complete and submit verification of eligibility and supporting documentation on the form provided by the Department.

(2) A recipient shall lose MADAP benefits, effective at the end of the month following the month the verification of eligibility is due, if the recipient fails to attest to continued eligibility for MADAP.

(3) The Department shall:

(a) Enroll an applicant who has been determined eligible with the stipulation that continued eligibility must be verified by the Department every 6 months;

(b) Establish enrollment in MADAP beginning on the first day of the month in which the:

(i) Department approves the application; or

(ii) Recipient will need to access medications through MADAP;

(c) Redetermine eligibility if the Department receives information that may affect continued eligibility; and

(d) Send any relevant verification of eligibility forms at least 45 calendar days before the forms are due to be submitted to the Department.