In that event, HCFA will only provide FFP in that amount rather than in the amount actually paid for the service by the individual. Under Federal law, State policies and procedures must ensure that eligibility is determined and services provided in a manner consistent with simplicity of administration and the best interests of the applicant or recipient. States should select reinstatement periods that allow reasonable time for the State to complete proper redeterminations of ongoing eligibility and for reinstatees to access services and to provide information to the State that is necessary for the redetermination of ongoing eligibility. States that have developed reinstatement procedures have typically reinstated individuals and families for a period of 60 or 90 days. If a State has properly determined that a reinstated individual is no longer eligible for Medicaid, it may terminate the case at that time or at the end of the reinstatement period, provided that it gives the individual timely and adequate notice of the proposed termination and the opportunity to appeal the redetermination decision as required under Federal regulation 42 CFR 431.220.
States have several options.
States also may consider months prior to the original termination. In addition, States have the option to make actual determinations of eligibility under Section 1931 for each month in the reinstatement period and count only those months during which the family actually met all Section 1931 eligibility requirements. HCFA encourages States to take advantage of those options that expand health care coverage to working families and children.