Notifying Participants of Actions Regarding Their Benefits
FAA has the responsibility to notify the participant of actions regarding their benefits unless policy permits no notification.
Policy
A notice from FAA to a participant is required to communicate with the participant of any actions FAA takes on their application or case.
Participants with a visual impairment may request a large print notice in any of the following ways:
●By calling (855) 432-7587 Monday – Friday, 7:00 a.m. to 6:00 p.m.
●On the Application for Benefits (FAA-0001A) form
●Online on the HEAplus Application (See https://www.healthearizonaplus.gov/)
A notice from FAA to a participant is required for all of the following actions:
●Approval
An approval notice is sent when a new or renewal application is approved or when a request for replacement benefits is approved. This includes approvals for No Pay Status and applications with a denied month and an approved month.
●Change in Benefit
A closure notice is sent when a change is reported and the participant fails to provide required verification or no longer meets the eligibility requirements.
●Denial
A denial notice is sent when a new application or a renewal application is submitted, and the participant fails to provide required verification or no longer meets the eligibility requirements.
●Change in Benefits
A notice is sent when a change occurs and benefits increase or decrease.
NOTE FAA sends a notice when a change is reported and there is no change in benefits.
●Information Request
An information request notice is sent when a determination cannot be made due to missing required verification. The notice allows ten calendar days(g) for the verification to be returned.
●Benefits are Ending or Renewal
For NA, a Notice of Expiration is sent when the approval period is coming to an end and another application and interview needs to be completed by the participant to continue benefits.
For CA, a Renewal Notice is sent when the approval period is coming to an end and another application and interview needs to be completed by the participant to renew benefits.
There are some situations when a notice is not sent. Most notices are mailed with adequate notice or adverse action to allow the participant time to prepare for a change in benefits. See all of the following for notice mailing requirements:
Adequate Notice
An adequate notice is a notice of action which is sent to the budgetary unit before benefits are affected. The notice is mailed before the effective date of the action.
For NA, adequate notice is sent when any of the following situations occurs:
●There is an NA benefit increase.
●When a participant verbally requests to stop benefits and FAA is unable to determine the reason for the request. (See NA Voluntary Withdrawal for information about stopping NA benefits.)
●When the participant fails to respond to the second Mid Approval Contact Form (X027) notice during the Mid Approval Contact (MAC) process.
NOTE For MAC, the notice must be received by the participant before the participant’s NA issuance date. The notice is sent with the automatic MAC process to provide adequate notice.
For CA, adequate notice is sent when any of the following occurs:
●There is a CA benefit increase.
●FAA has received verification confirming the death of a participant.
●The participant provides information and signs a statement of understanding that the information provided may result in closure or a decrease in benefits.
●The participant's whereabouts are unknown. FAA received returned mail indicating no known forwarding address.
●FAA verifies that a participant has been determined eligible for CA in another state.
●FAA has confirmed the death of the CA payee and no CA emergency payee is available.
●The participant requested either in writing or verbally that their benefits be stopped. See CA Voluntary Withdrawal for information about stopping CA benefits.
●The participant is admitted to a facility where their needs are being met. This includes, and is not limited to, all of the following:
Placement in skilled nursing care
Intermediate care (Extended care)
Incarceration
Long term hospitalization (Not expected to return home)
●State or federal governments initiate changes (also known as mass changes) that affect a significant portion of the entire caseload.
●The Two Parent Employment Program (TPEP) benefit is withheld or the TPEP case closes because of noncompliance with Jobs.
●A CA child is removed from the home as a result of a court order or voluntarily placed in foster care by the child's legal guardian.
No Notice Required for NA
FAA is not required to send a notice in all of the following situations:
●Benefits are stopped due to a move out of state by all participants.
●Benefits are stopped due to the death of all participants.
●Expedited NA with postponed verification.
NOTE The participant is advised on the NA decision notice at the time of the expedited approval that NA benefits are stopped when the listed postponed verification is not provided by the due date. No additional closure notice is required.
●Approval of CA that decreases NA, when all the following apply:
All the participants jointly apply for NA and CA.
The participants have been receiving NA pending the approval of CA.
The participant received an NA approval notice informing them that NA benefits would be reduced when CA is approved.
●A mass change was affected.
●The participants request in writing that their benefits be stopped. (For additional information about stopping NA benefits, see NA Voluntary Withdrawal.)
●Stopping NA benefits of residents of a drug and alcohol treatment center or a group living arrangement (GLA) when any of the following occur:
The facility loses its certification from the appropriate state agency.
The facility loses its status as a representative because it has been disqualified by the Food and Nutrition Service (FNS) as an NA retailer.
●The end of an increased payment to restore lost NA benefits.
●The budgetary unit was previously notified in writing of the date an increased payment would stop.
●When the Overpayment Unit receives notification from the Office of Accounts and Receivable Collections (OARC) that the participant has been disqualified for an Intentional Program Violation (IPV). For additional information, see Administrative Disqualification Procedures.
●The budgetary unit was notified of the action to decrease or stop benefits by an administrative disqualification hearing or a court of appropriate jurisdiction who imposed the penalty.
●A benefit decreases because of imposing an automatic recoupment of a claim.
Notice of Adverse Action (NOAA)
A Notice of Adverse Action (NOAA) is sent to the participant when benefits are decreased or stopped, unless the reason for the action is listed in one of the following:
For CA, NOAA is required when a change in the CA payee occurs.
An Intentional Program Violation (IPV) disqualification is reported from another state. (See IPV – electronic Disqualified Recipient System (eDRS) for policies and procedures.)
FAA sends the NOAA so the participant receives the notice no later than ten days before the first day of the effective month of the decrease or termination.
For an IPV disqualification, NOAA is not required when the Office of Accounts Receivable and Collections (OARC) has notified the participant of the disqualification. OARC sends copies of the disqualification letters to the Overpayment Unit. (See Administrative Disqualifications Procedures - FAA Responsibilities for policies and procedures.)
NA Notice of Expiration (NOE) Public
AZTECS mails a NOE to each budgetary unit, so the notice is received as any of the following:
●At least one day before the last month of the approval period.
●No earlier than the next to last month of the approval period.
AZTECS automatically creates an NOE on the first day of the month prior to expiration.
AZTECS does not automatically generate the NOE to budgetary units approved for three months or less when the approval is keyed after the AZTECS NOE issuance date.
Legal Authorities
7 CFR 271.2
7 CFR 273.2(i)(4)
7 CFR 273.12(a)(4)
7 CFR 273.13
CFR 273.16
45 CFR 206
AAC R6-12-902.G
AAC R6-12-907.D
AAC R6-12-907
AAC R6-1206
ARS 46-215
last revised 04/01/2024