Changes made to income, expense or household evidence for Integrated Cases which have a Spend Down product delivery case will have their Spend Down product delivery cases reassessed. A household member may have been eligible for different Medical Assistance coverage types in different Spend Down periods, and it is therefore possible that he or she may have a few different Spend Down product delivery cases on the same Integrated Case. The household member can only have one current (open, approved, active, rejected, suspended) Spend Down product delivery case in any Spend Down period.
Changes to Income and/or Expenses evidence, for example Child Support, Dependent Care, Employment evidence, may reduce or increase the income and may also trigger reassessment.
The addition or removal of a household member may also increase or decrease the income of the household, thus requiring reassessment.
An income change tolerance amount is defined as an environment variable which when set, will prevent any system action on existing Spend Down periods provided the income evidence changes are within the agreed tolerance amount of the original total net income of the income unit. The tolerance is defined as a percentage of the total net income and is defaulted to 1% within the system. The income change tolerance only applies to changes in income; it does not apply to changes in income limits.
If the evidence change occurs in the current period, only the current period is affected. If the evidence change effects a past period, all periods from that point onwards will be reassessed.
It is understood that household members must provide details of change in circumstances/evidence within a timely manner, normally within 10 days of the occurrence of the change and thus most evidence changes only effect the current period. However it is necessary to support reassessment across past periods to cater for acceptable late arriving evidence or inaccurate evidence details entered in error by the caseworker.