Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: COVID-19 MO HealthNet (MHN) Coverage for Positive COVID-19 Diagnosis
DISCUSSION:
FSD will provide MO HealthNet coverage for individuals between the ages of 19 and 64 who have a positive COVID-19 diagnosis and meet current MHABD eligibility guidelines, including income and resources.
Applications for individuals who have a positive COVID-19 diagnosis will be accepted on a signed IM-1MA application form.
- To expedite the process, applications for individuals who have a positive COVID-19 diagnosis can be submitted to FSD.COVIDAPPS@dss.mo.gov.
- Submitting verification of the COVID-19 diagnosis with the application will allow for expedited processing. Verification of a positive COVID-19 diagnosis includes, but is not limited to, a letter signed by the physician, lab results, discharge summary, or hospital records that clearly state the diagnosis.
- NOTE: FSD must accept fillable applications from hospitals, providers, friends and/or family with an electronic signature that includes a statement from the applicant who is quarantined and wishing to apply for Missouri Medicaid.
If eligible, COVID-19 MHN coverage will begin the first day of the month of application in which a positive COVID-19 was performed and the determination of disability will be authorized for 90 days and reassessed moving forward. To authorize coverage for the month of a test completed prior to the month of application, indicate a request for prior quarter coverage on the REQUEST/FM0G screen and entering the date of the diagnosis on the DISABLED/FMMX screen with the COV code. When entering an approval ensure that only the appropriate months are authorized.
- Additional information will be released when available regarding participants that continue to have a positive COVID-19 diagnosis at the end of the 90 day time period.
- This coverage will remain in effect until the health emergency ends or the individual is no longer considered disabled whichever occurs last.
NOTE: Utilize prior quarter as needed for medical services that are related to a positive COVID-19 test but not prior to February 1, 2020. System updates allow for coverage based on a COVID-19 diagnosis to be authorized back to March 1, 2020. When applicable, staff must use the Worker Initiated Budget Calculation screen in order to authorize coverage for February 2020.
Processing applications:
An application for COVID-19 coverage must be registered in the same manner as an MHABD-PTD application. These applications are a high priority.
- Use the standard income and resource limits for the MHABD-PTD program.
- Verification of a positive COVID-19 diagnosis is required.
- To be eligible, individuals must be between the ages of 19 and 64.
- Accept self-attestation of income and resources unless questionable, with the exception of trusts and annuities. Trusts and annuities must still be submitted to the Program and Policy unit for interpretation.
- Staff must explore all avenues available to FSD to verify citizenship and identity before requesting verification from the participant.
- The COVID-19 diagnosis will be captured in FAMIS on the DISABLED/FMMX screen using code “COV.”
- The begin date is the date of the test that resulted in a positive COVID-19 diagnosis.
- Only enter hard copy verification of the COV code if the individual is within the designated age range and has a positive COVID-19 diagnosis.
- Coverage will be displayed as Spend Down or Non-Spend Down coverage. A new ME code will not be created for this program and coverage will show as ME 13. If staff need to identify that coverage was authorized due to a positive COVID-19 test, this information can be located by checking the DISABLED/FMMX screen, or reviewing the technical details screen associated with the authorization.
- Programming is being completed to add specific information to the approval notice sent to eligible individuals who have a positive COVID-19 diagnosis.
- Enter a comment on the Eligibility Unit Member Role (EUMEMROL/FM3Z) screen with label “COVID-19 Application” on every case approved for coverage due to positive diagnosis.
- Include a comment on each income or resource entry that is verified with self-attestation with label “COVID-19 Self-Attestation” on every case approved for coverage due to positive diagnosis. The body of the comment should include the following statement: “Self-attestation accepted as verification due to special circumstances. 42 CFR §435.952(c)(3)”
NOTE: MAGI coverage should be explored if coverage could be offered through Family MHN programs
Questions regarding the entry of COVID-19 MHN coverage may be sent via email to Cole.MHNPolicy@dss.mo.gov.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/rr/vb