IM-34 COVID-19 FAMILY HEALTHCARE (MAGI) CHIP 75 THIRTY DAY WAITING PERIOD WAIVED

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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 FAMILY HEALTHCARE (MAGI) CHIP 75 THIRTY DAY WAITING PERIOD WAIVED

DISCUSSION:

Waive the thirty day waiting period for participants approved for Children’s Health Insurance Program (CHIP) 75 for any application received on or after March 18, 2020.  Enter CHIP Special Needs evidence in MEDES to prevent the thirty day waiting period while still allowing MO HealthNet Division (MHD) to send invoices.     

 

Application Case:

  • CHIP Special Needs evidence is tied to Application Details. The current Yes segment for the CHIP 75 child(ren) must be selected when creating this evidence.
    • When going through the caseworker portal this evidence will be created when the Application Case is submitted based on the questions in the portal.
  • Leave the box blank labeled “Require Verification, even if evidence does not indicate eligibility for CHIP 75?” in the CHIP Special Needs evidence. Verify evidence on the Application Case and run Check Eligibility.  If an applicant looks to be CHIP 75 eligible verification will create for the CHIP Special Needs.
    • Use the verification item “MHD Administration Request”.
    • Include a comment with the label COVID-19 stating, “Special Needs entered due to special circumstances. 42 CFR 435.952(c)(3).”
      • During COVID-19 we are not requesting any Special Needs verification.
    • If an IM-31A needs to be sent for other pending items on the case this can be sent, but do not include the CHIP Special Needs on the request.
    • If able to Authorize the Application Case run Check Eligibility again after all the items to verify are cleared and then Authorize the Application Case.
      • There will be no thirty day waiting period now for the CHIP 75 child(ren).

 

Integrated Case (IC):

  • CHIP Special Needs evidence must be tied to the current Yes Application Details segment for any child(ren) who may be CHIP 75 eligible. To create CHIP Special Needs and tie it to the Application Details evidence:
    • Add the CHIP Special Needs via the Dashboard, which is found under Application Details.
      • Select the current Application Details Evidence for the potential CHIP 75 child.
      • Use the default date for Received Date. MEDES will auto populate the start date when reviewing the evidence to the last Yes Application Details segment.
      • Leave the box blank labeled “Require Verification, even if evidence does not indicate eligibility for CHIP 75?” in the CHIP Special Needs evidence.
      • Select Save.
      • Repeat for any child who may CHIP 75 eligible.
    • If an IM-31A needs to be sent after verification is completed follow the process of not Applying Changes.
      • If the verification comes back the follow-up will verify the evidence and Apply Changes.
      • Once Apply Changes are completed MEDES will create CHIP Special Needs to be verified.
      • Use the verification item of “MHD Administration Request”.
      • Include a comment with the label COVID-19 stating, “Special Needs entered due to special circumstances. 42 CFR 435.952(c)(3).”
        • During COVID-19 we are not requesting any Special Needs verification.
      • Apply the verified CHIP Special Needs evidence to the IC, review proposed determination, and Finalize.
    • If no IM-31A needs to be sent Apply Changes to the IC.
      • After Changes are applied MEDES will create CHIP Special Needs to be verified.
      • Use the verification item of “MHD Administration Request”.
      • Include a comment with the label COVID-19 stating, “Special Needs entered due to special circumstances. 42 CFR 435.952(c)(3).”
        • During COVID-19 we are not requesting any Special Needs verification.
      • Apply the verified CHIP Special Needs evidence to the IC, review proposed determination, and Finalize.
        • There will be no thirty day waiting period for any child who is CHIP 75 eligible.
      • Coverage will begin the date the premium is received.
      • Applications that have already been approved will be corrected and do not require further action by staff.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/kg/ns