441—87.3(217) Enrollment.
	87.3(1) Application. An individual who requests assistance for family planning services shall file an application Form 470-5485, Family Planning Program Application. A woman eligible under paragraph 87.2(1)“a” is not required to file an application for assistance under this program. The department will automatically redetermine eligibility upon loss of other Medicaid eligibility within 12 months after the month when the 60-day postpartum period ends.
	87.3(2) Place of filing. An application may be filed at any department office or authorized Title X family planning agency.
	87.3(3) Information or verification needed to determine eligibility. The department shall notify the applicant, authorized representative, or responsible person in writing of the information or verification required to establish eligibility. This notice shall be provided to the applicant, authorized representative, or responsible person personally or by mail or fax.
	a. 	The department shall allow the applicant, authorized representative, or responsible person ten calendar days to supply the information or verification requested.
	b. 	The department may extend the deadline for a reasonable period of time when the applicant, authorized representative, or responsible person is making reasonable efforts but is unable to secure the required information or verification.
	c. 	If benefits are denied for failure to provide information or verification and the information or verification is provided within 14 calendar days of the effective date of the denial, the department shall complete the eligibility determination as though the information or verification were received timely. If the fourteenth calendar day falls on a weekend or state holiday, the applicant, authorized representative, or responsible person shall have until the next business day to provide the information.
	87.3(4) Annual review. An individual who requests that assistance continue for family planning services shall complete Form 470-4071, Family Planning Program Review. The member must submit the completed review form before the end of the eligibility period to any location specified in subrule 87.3(2).
	87.3(5) Time limit for decision. An application or review form shall be processed by the family planning agency with which the application was filed. A determination of eligibility shall be made within 45 days of receipt of the application or review form.
	87.3(6) Notice of decision. The individual shall be notified in writing of the decision regarding eligibility for the family planning program.
[ARC 3199C, IAB 7/19/17, effective 7/1/17]