Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: WAIVERS APPROVED BY CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FOR ALL MO HEALTHNET (MHN) ANNUAL RENEWALS
MANUAL REVISION #
0890.010.00
1895.010.00
DISCUSSION:
An increased number of eligibility and enrollment actions must be completed when MHN annual renewals resume on April 1, 2023. CMS has approved Missouri to use the following waivers to help expedite renewal processing, protect participants from inappropriate terminations, and reduce administrative burden. Headings shown below are the official CMS waiver titles.
These waivers are effective April 1, 2023 and will continue until further notice.
1. Renewal for Individuals Based on SNAP Eligibility
Renew MHN eligibility for participants under 65 years of age who are receiving Supplemental Nutrition Assistance Program (SNAP) benefits, despite the differences in household composition and income-counting rules.
Note: This waiver allows the “Targeted Enrollment SNAP Strategy” flexibility currently used for Modified Adjusted Gross Income (MAGI) applications to also be used for all MHN annual renewals.
2. Ex Parte Renewal for Individuals with No Income and No Data Returned
When using the ex parte (not requiring information from the individual) renewal process for non-CHIP cases, complete the income determination without requesting additional income information or documentation if:
- An attestation of zero-dollar income was verified at an initial application or renewal completed no earlier than March 2019; and
- No income information is reported on an electronic source, such as IMES, IIVE, or The Work Number.
Continue to take appropriate steps to complete a determination of non-financial eligibility requirements.
Note: This waiver does not apply to CHIP cases.
3. Facilitating Renewal for Individuals with no Asset Verification System (AVS) Data Returned within a Reasonable Timeframe
Assume there has been no change in resources and complete the ex parte (not requiring information from the individual) renewal process without any further verification of assets when:
- No information is returned through Accuity; or
- Accuity response is not returned within 15 days.
If information from Accuity indicating potential ineligibility is received after a renewal has been completed, treat the information as a change in circumstance.
4. Extended Timeframe to Take Final Administrative Action on Fair Hearing Requests
All participants must remain active on MHN pending the outcome of a fair hearing decision regardless of whether the participant has requested that their MHN benefits continue. This flexibility does not extend the timeframe to take final administrative action when benefits cannot be provided pending the outcome of a fair hearing, such as a denial of eligibility for a new applicant.
- Staff who submit the hearing request must place both the Adverse Action Benefit Reduction (AABR) and No Change (NOCH) actions on hold before submitting the hearing request handoff. Information on how to change an adverse action status can be found in FAMIS Resources.
- The Income Maintenance (IM) Hearing Unit is responsible for reinstating coverage back to the date of the action for any person who requests a fair hearing after the date of action.
Note: Missouri will not recoup the cost of MHN benefits provided to the participant while the fair hearing is pending, regardless of whether the fair hearing ultimately upholds the agency’s determination.
This memo has been added to the following MO HealthNet for the Aged, Blind, and Disabled (MHABD) and Family MO HealthNet (MAGI) manual sections:
0890.010.00 Transition Period
1895.010.00 Transition Period
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/sh