A medical assistance recipient shall immediately notify the Department of Human Services or the Oregon Health Authority, if required, of the receipt or possession of property or income or other change in circumstances that directly affects the eligibility of the recipient to receive medical assistance, or that directly affects the amount of medical assistance for which the recipient is eligible. Failure to give the notice shall entitle the department or the authority to recover from the recipient the amount of assistance improperly disbursed by reason thereof.
(a) The department or the authority shall redetermine the eligibility of a medical assistance recipient at intervals specified by federal law.
The department and the authority shall redetermine eligibility under this subsection on the basis of information available to the department and the authority and may not require the recipient to provide information if the department or the authority is able to determine eligibility based on information in the recipient’s record or through other information that is available to the department or the authority.
Notwithstanding subsection (2) of this section, if the department or the authority receives information about a change in a medical assistance recipient’s circumstances that may affect eligibility for medical assistance, the department or the authority shall promptly redetermine eligibility.
If the department or the authority determines that a medical assistance recipient no longer qualifies for the medical assistance program in which the recipient is enrolled, the department or the authority must determine eligibility for other medical assistance programs, potential eligibility for the health insurance exchange, premium tax credits and cost-sharing reductions before terminating the recipient’s medical assistance. If the recipient appears to qualify for the exchange, premium tax credits or cost-sharing reductions, the department or the authority shall promptly transfer the recipient’s record to the exchange to process those benefits. [Formerly 414.057; 2011 c.720 §104; 2013 c.688 §44]