A deemed IEP may be established for an individual born on the first day of a month
who files an enrollment request in the first month after the IEP.
Since persons born on the first day of a month are ordinarily unaware that they actually
attain a given age in the preceding month, the deemed IEP provision will be applied
without further development.
IMPORTANT: If there is evidence in file that demonstrates that the enrollee knew the “prior-month” attainment rule, do not establish a deemed IEP.
EXAMPLE: Mr. Allen DB 3/1/20, enrolled on 6/22/85. Although his enrollment request was filed
in the month after expiration of his actual IEP, a deemed IEP of 12/84-6/85 is established
and SMI coverage is effective 9/1/85.
On the other hand, if Mr. Allen had enrolled in 3/85, his SMI coverage would be effective
5/1/85 (see HI 00805.165 B.3.). A deemed IEP could not be established since he enrolled during his actual IEP.