IM-11 INTRODUCTION OF SUSPENSION OF MO HEALTHNET BENEFITS FOR INCARCERATED PARTICIPANTS FOR ALL MO HEALTHNET PROGRAMS

Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  KIM EVANS,  DIRECTOR

SUBJECT:  INTRODUCTION OF SUSPENSION OF MO HEALTHNET BENEFITS FOR INCARCERATED PARTICIPANTS FOR ALL MO HEALTHNET PROGRAMS

MANUAL REVISION #07

0105.040.30

0840.020.00

1020.005.00

1885.015.00

1885.040.00

FORMS REVISION #04

IM-33 SUSPENSION

IM-80 Suspension

 

DISCUSSION:

The 2018 SUPPORT for Patients and Communities Act (H.R. 6, P.L. 115-271) and SB 514 (2019) enacted RSMo §217.930 and §221.125 to require that MO HealthNet (MHN) benefits are suspended for individuals who are incarcerated, rather than ending his/her benefits and closing his/her case. This policy change affects all MO HealthNet for Aged, Blind, and Disabled (MHABD) and Family MO HealthNet (MAGI) programs. This applies only to participants who became incarcerated AFTER August 28, 2019.

Manual sections have been added to the Family MO HealthNet manual and to the MO HealthNet for the Aged, Blind, and Disabled manual to update information regarding participants receiving MHN benefits. For specific information reguarding each program, refer to 1885.040.00 Suspension of MAGI Benefits for Incarcerated Individuals and 0840.020.00 Suspending Incarcerated Participants.

To update information for MHN participants that are incarcerated, there will be an assigned unit to make changes in FAMIS and MEDES. All information regarding incarcerated household members received by staff at the Service Centers should be sent to MHNJailsandDOCReport@ip.sp.mo.gov.

Until future system changes are completed, it may appear that there was no change made to cases in FAMIS and MEDES when an individual is incarcerated, but eligibility is suspended and changes are made by MO HealthNet Division (MHD) to prohibit medical expenses to be paid for a suspended participant while  incarcerated.  Staff should review FAMIS comments on EUMEMROL and MEDES comments on the Head of Household’s Client Contact tab, under Notes. Comments should include at a minimum: when a participant became incarcerated, an expected release date, and when information was sent to MHD to suspend benefits.

Participants will be notified of actions taken on cases regarding suspended benefits: when benefits are suspended, when a redetermination is completed and a participant’s benefits are restored, and if a redetermination is completed and a new level of care is authorized. These notices will be sent as IM-33 Suspension and IM-80 Suspension.

If a redetermination and ex parte review is completed and the participant is no longer eligible for any program, a standard adverse action will be sent regarding the reason he/she is no longer eligible (example: no eligible child in the home, over the income limit for MO HealthNet for Families, or no longer meeting the disability requirements).

Changes were also made to update manual sections that referred to closing MHN cases or ending eligibility for MHN participants that are incarcerated. See updates below:

General Information Manual:

0105.040.30 MO HealthNet Application for Inmates in Custody of Department of Corrections

MHABD, December 1973 Eligibility Requirements Manual:

1020.005.00 Inmate of Public Institution

 

MAGI:

1885.015.00 REMOVING A PERSON

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • All questions regarding this policy should follow normal supervisory channels.

 

KE/cj/ams