Oregon Oregon Health Authority, Health Systems Division: Medical Assistance Programs

Rule Rule 410-200-0235
Changes That Must Be Reported

(1) Reporting requirements described in this rule apply to any individual whose information is considered in determining eligibility for any case member.
(2) An individual or someone authorized to act on the individuals behalf shall report the following changes in circumstances within 10 calendar days of its occurrence:
(a) The receipt or loss of health care coverage;
(b) A change in mailing or residential address;
(c) A change in legal name;
(d) A change in pregnancy status;
(e) A change in tax-filing status;
(f) A change in citizenship or immigration status of an applicant or recipient;
(g) Someone joins or permanently leaves the household;
(h) Someone becomes an inmate, or is released from the public institution in which they were an inmate, as described in OAR 410-200-0015 (General Definitions)(50);
(i) For all HSD Medical Programs except MAGI CHIP, a change in availability of employer-sponsored health insurance;
(j) For the MAGI Parent or Caretaker Relative and EXT programs, when the beneficiary no longer has a dependent child living in the home, including:
(A) The only dependent child leaves the household; or
(B) The only dependent child is 18 years old and not a full-time student in a secondary school or equivalent vocational or technical training.
(k) An EDG member age 19 or older experiences a change in income, including:
(A) A change in source of income;
(B) A change in employment status:
(i) For a new job, the change occurs the first day of the new job;
(ii) For a job separation, the change occurs on the last day of employment.
(C) A change in earned income more than $100 per month. The change occurs upon the receipt by the beneficiary of the first paycheck from a new job or the first paycheck reflecting the updated income amount;
(D) A change in unearned income more than $50 per month. The change occurs the day the beneficiary receives the new or changed payment.
(3) Individuals shall report a claim for personal injury within 10 calendar days of its occurrence. The following information shall be reported:
(a) The names and addresses of all parties against whom the action is brought or claim is made;
(b) A copy of each claim demand; and
(c) If an action is brought, identification of the case number and the county where the action is filed.
(4) Changes may be reported via the Internet, by telephone, via mail, in person, and through other commonly available electronic means.
(5) A change is considered reported on the date the information is received by the Agency.
(6) A change reported for one program is considered reported for all programs administered by the Agency in which the beneficiary participates.
(7) The following changes are not required to be reported:
(a) Periodic cost-of-living adjustments to the federal Black Lung Program, SSB, SSDI, SSI, and veterans assistance under Title 38 of the United States Code;
(b) Changes in eligibility criteria based on legislative or regulatory actions.

Last accessed
Jun. 8, 2021