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 NEW FORMS FOR SUSPENDED MO HEALTHNET (MHN) BENEFITS FOR INCARCERATED PARTICIPANTS
FORMS REVISION #05
IM-150 SUSPENDING MO HEALTHNET PARTICIPANTS
IM-151 REQUESTING INPATIENT COVERAGE
IM-152 REPORTING RELEASE OF MO HEALTHNET PARTICIPANTS
DISCUSSION:
IM Memo #11 from February 19, 2020, introduced new suspension policy for individuals who 1885.040.00 Suspension of MAGI Benefits for Incarcerated Individuals and 0840.020.00 Suspending Incarcerated Participants.
SB 514 (2019) enacted RSMo §217.930 and §221.125 and requires that Missouri correctional facilities and jails report when an active MO HealthNet participant is incarcerated. Department of Corrections (DOC) must report within 20 days; and city, county and private jails must report within 10 days after determining that an incarcerated individual is receiving MO HealthNet.
Information should be reported by the DOC and local jails within the required timeframes. A new form was created for the correctional facilities to use, Suspending MO HealthNet Participants (IM-150). This form collects information that allows FSD to determine if the incarcerated individual is a MO HealthNet participant and allows MO HealthNet Divicion (MHD) to suspend benefits and stop paying medical claims for the participant.
While a suspended participant is incarcerated, there may be medical situations that require him/her to be admitted to the hospital or other medical facility for 24 hours or more, for treatment. These participants may have their suspended benefits restored to allow for medical expenses to be paid. DOC and local jails can report this information using the new form, Requesting Inpatient Coverage (IM-151), to collect information regarding the inpatient stay.
When a participant is going to be released, FSD must complete a redetermination to evaluate if the participant’s eligibility has stayed the same, changed to a different level of care, or if he/she is no longer eligible. To complete this redetermination, FSD needs to collect information from the participant, DOC/jail, or the other household members who are still in the home. DOC is required to report this information within 45 days of the anticipated release date. DOC and local jails can use the new form, Reporting the Release of MO HealthNet Participants (IM-152), to report the participant’s anticipated circumstances at release.
FSD staff should also use these forms to collect information from participants or household members who report an incarcerated participant, or a suspended participant who has been released. If staff in the Service Centers are notified of a participant, or household member, who has become incarcerated, or a suspended participant who has been released but benefits have not been restored yet, please complete the Suspending MO HealthNet Participants (IM-150) or the Reporting the Release of MO HealthNet Participants (IM-152). These forms do not have to be signed and can be completed over the phone. Email these forms to: MHNJailsandDOCReport@ip.sp.mo.gov , or FAX to: 573-751-0050.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- All questions regarding this policy should follow normal supervisory channels.
KE/cj/ams