MO HealthNet for the Aged, Blind, and Disabled (MHABD) applications rejected due to verification not provided or participant’s failure to cooperate may be cancel rejected when:
- the application was rejected in error
- a hearing decision requires this action, or
- ALL requested information is provided by the application due date
Agency errors occur when staff fail to act promptly on information provided by the participant and/or verification provided, causing the application to reject. Applications rejected due to an agency error must be cancel rejected. See FAMIS Resources for guides.
MHABD applications rejected for failure to provide information or failure to cooperate may be cancel rejected if ALL requested information is received by the application due date.
Application due dates are referenced in MHABD manual section 0804.005.00 MHABD Application Timeframes.
If all necessary information is not provided by the original due date of the application, no further action is necessary and the participant would need to reapply.
EXAMPLE: Bob applied for MHABD on April 25 and his application is due 45 days from the application date, on June 9. On April 25, a Request for Information notification was generated requesting verification of his income. The notification expired on May 5. The requested information was not received, and Bob did not request more time, so staff rejected the application.
On May 25, Bob provided the information. Staff cancel rejected the application and processed using the original application date of April 25. If the requested information had been provided after June 9, the rejection could not be canceled and he would have had to reapply.
Add a Person Requests
An add a person application will have different processing guidelines depending on if the person is requesting coverage or being added as an included household member.
- If the person being added is requesting coverage:
- Follow the same timeframes as an initial application.
- If the case closed due to failure to provide requested verification and ALL requested verification is provided within the cancel rejection timeframe, cancel close the case.
- After authorizing the cancel close, register a new add a person application using the original application date.
- If the person being added is not requesting coverage:
- Consider this a change in circumstance, not an application.
- If the case closes, only the cancel close policy would apply, not the cancel rejection policy. Refer to 0840.015.10 Reopening Closed Cases.
EXAMPLE: On July 16, Mary requested to add coverage to her active MHABD case for her spouse, Louis, as he is permanently and totally disabled (PTD). FSD sent a Request for Information Notice and it expired on July 30 with no response from the participants. The case closed and the add a person application rejected on August 10.
- An application based on PTD is due within 90 days, or October 14th. Mary and Louis provide ALL of the requested information on October 12. Mary’s case must be cancel closed because the verification was provided before the cancel rejection timeframe, even though it was provided after the cancel closing timeframe.
- After cancel closing, staff must register an add a person application requesting benefits for Louis using July 16 (the original add a person request date) as the application date.
Cancel Rejections for Add a Category Requests
When a participant requests an additional benefit be added to their existing MO HealthNet (MHN) coverage, it is considered an add a category request. Follow application timeframes when applying the cancel rejection policy. Refer to 0840.015.10 Reopening Closed Cases.
Additions to existing MHN coverage include, but are not limited to:
- Adding QMB or SLMB
- Adding a grant such as Blind Pension (BP), Supplemental Aid to the Blind (SAB), or Supplemental Nursing Care (SNC)
NOTE: A new application is not required to move from one MO HealthNet program to another MO HealthNet only program. However, a signed application is required to move from a MHN only program to an MHABD Cash assistance program, such as BP, SAB, or SNC. A signed application may be required to move from QMB only, SLMB1 only, or SLMB2 only to other MHABD benefits.
Changing a category from one type of medical coverage to another is a change in circumstance. If the case closes, apply the cancel closing policy; do NOT apply the cancel rejection policy.
Changes in MHN category include, but are not limited to:
- A change from MHABD (Spend Down or Non-Spend Down) coverage to Ticket to Work Health Assurance (TWHA) coverage
- A change from MHABD (Spend Down or Non-Spend Down) coverage to Vendor or Home and Community Based Services (HCB) coverage
- A change from MO HealthNet for Disabled Children (MHDC) to Missouri’s Children with Developmental Disabilities (MOCDD)
- A change from Vendor coverage to MHABD (Spend Down or Non-Spend Down) coverage
- A change from MHABD (Spend Down or Non-Spend Down) coverage to 1619b coverage
NOTE: The MO HealthNet Division (MHD) Stakeholder Services Unit (formerly the Premium Collections Unit) must be notified when a MHABD Spend Down or Ticket to Work (TWHA) case is reopened for any reason.
The MHD Medicare Buy-In Unit must be notified when a QMB/SLMB case is reopened for any reason. Refer to FAMIS Resources for the current procedure for reopening Spend Down, TWHA, and QMB/SLMB cases.