Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: GATEWAY TO BETTER HEALTH (GTBH) PARTICIPANTS TO TRANSITION TO MO HEALTHNET ADULT EXPANSION GROUP (AEG)
DISCUSSION:
In May 2022, FSD requested a waiver from Centers for Medicare & Medicaid Services (CMS) under 1902(e)(14)(A) of the Social Security Act. CMS approved the waiver until October 31, 2022. This waiver allows FSD to use the most recent non-MAGI GTBH eligibility determination to determine eligibility for AEG, a MAGI based program, without requiring additional information or verification from the participant.
From now until October 31, 2022, FSD will take action to move all GTBH participants to AEG using available information. FSD will utilize information provided by the participant at the last application, review, or change of circumstance. Once found eligible, participants will receive an approval notice for AEG benefits, and a separate closing notice for GTBH benefits.
Due to the COVID-19 Public Health Emergency (PHE), some current MO HealthNet (MHN) participants may not be eligible for any MHN program, but continue to receive benefits due to the continuous coverage requirement. GTBH participants who are not eligible for AEG (or any other MHN program) will remain on GTBH until they are found eligible for another MHN program, the end of the PHE, or the expiration of the GTBH program, whichever occurs first.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/cj