IM-29 COVID-19: END OF EXTENSION FOR ALL SHOW ME HEALTHY BABIES (SMHB) PROGRAM COVERAGE

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: END OF EXTENSION FOR ALL SHOW ME HEALTHY BABIES (SMHB) PROGRAM COVERAGE                           

DISCUSSION:

The original posted memo IM-29 was redacted.  The following memo has corrected information.

Coverage under the SMHB program no longer includes extension of coverage during the Public Health Emergency (PHE).  The Family Support Division has received clarification from the Centers for Medicare and Medicaid Services (CMS) that because SMHB is a Children’s Health Insurance Program (CHIP), participants should not retain coverage beyond normal timeframes.

Beginning April 26, 2021 the following levels of coverage will follow pre-PHE guidelines and will no longer be extended:

  • SMHB pregnant women (citizen or qualified immigrant mother) will move to a 60-day post-partum period after delivery. The post-partum coverage ends on the last day of the month containing the 60th day after the birth of the child or the pregnancy terminates.
  • SMHB pregnant women (non-citizen/non-qualified immigrant mother) will have full coverage until ten days after the discharge date after delivery, and will include one (1) post-partum visit. The system allows coverage for 10 days after the due date or if updated then the actual discharge date and then closes.
  • SMHB Newborns (citizen or qualified immigrant mother) will end when the child turns age one (1), unless determined eligible for further coverage.
  • SMHB Newborns (non-citizen/non-qualified immigrant mother) will end when the child turns age one (1), unless determined eligible for further coverage. The only exception to this is that FSD must manually do an ex parte review for SMHB Newborns receiving CHIP74 or 75 level of care with no premium until the PHE ends.

Fifteen days before the SMHB coverage is due to end, the COVID EEE evidence will be systematically end dated allowing the Adverse Action Notice (IM-80) to be sent to the participant.  The IM-80 will be followed by an Action Notice (IM-33C) ten days later. This process will continue for each SMHB case as it nears its coverage end date.  The system will continue this process until 30 days after the PHE ends.  At the end of that 30 days, sending an IM-80 at the termination of SMHB coverage will stop. Any SMHB cases approved on or after the PHE end date will follow normal (pre-PHE) timeframe and notice guidelines.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/df