Author: Patrick Ellison

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REASONABLE OPPORTUNITY (RO) POLICY UPDATED FOR MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
0810.015.00
1805.000.05
1805.015.00
1830.020.00
1805.000.05.05 obsolete

FORM REVISION #
IM-40

DISCUSSION:

RO policy for MHN programs is updated to align policy for MO HealthNet for the Aged, Blind, and Disabled (MHABD) and Family MO HealthNet (MAGI) programs, and to comply with federal regulations.

Changes to MAGI and MHABD policy can be found in section 1805.000.05 Reasonable Opportunity of the MAGI Manual.

• RO periods are extended to 95 days to allow time for mail.
• Require a signed attestation of citizenship or immigration status before granting an RO period. A signed application serves this purpose. A new form was also created to meet this need without an application (IM-40 Citizen/National/Eligible Immigrant Attestation), and can be located in the internal forms manual.
• Allow RO for identity when identity is required for the purpose of verifying citizenship/eligible immigrant status (such as when the participant only provides a birth certificate.)
• Include specific language on benefit approval letters when a participant’s coverage is approved pending verification of citizenship, nationality, or eligible immigrant status.
  • Changes to the eligibility systems to automate this process are pending. When the changes are complete, Program and Policy will issue an update.
    • Until the changes are complete, send a manual approval letter with the specific language to all participants approved while pending verification of citizenship, nationality, or eligible immigrant status. Refer to 1805.000.05 Reasonable Opportunity for specific language.
  • Save a copy of the manual letter in the electronic case record and document the letter.
• Do not limit RO periods per participant.

EXAMPLE: Rita attested to citizenship on her application and was given a 95-day RO period to provide her birth certificate. She did not provide the document or request an extension so her coverage closed. She reapplied and was given another 95-day RO period.

1805.000.05.05 has been obsoleted in the MAGI manual.

1830.020.00 Prior Quarter (PQ) and 0810.015.00 Prior Quarter Coverage are updated to allow RO during PQ months, if ongoing coverage is approved.

1805.015.00 Social Security Number (SSN) contains an update for MAGI cases:

• Do not allow an RO period for a Social Security Number (SSN).

EXCEPTION: Continue to allow an RO period for Newborns without an SSN.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Review FAMIS and MEDES Resources for related guides.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  NATIONAL CHANGE OF ADDRESS FLEXIBILITY APPROVED FOR MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
0890.005.00
1895.005.00                   

DISCUSSION:

The Centers for Medicare and Medicaid Services (CMS) has approved Missouri Department of Social Services (DSS) request to implement the following address change flexibility to promote retention of eligible MHN individuals. This flexibility will remain in effect through the Public Health Emergency (PHE) unwinding period.

Using the U.S. Postal Service (USPS) National Change of Address (NCOA) Database and USPS Returned Mail to Update Beneficiary Contact Information

Accept updated participant in-state contact information received from NCOA or USPS returned mail as reliable without additional confirmation from the participant. In-state address changes reported by NCOA or USPS returned mail should be updated without first sending a notice to the participant address on file.

Address changes due to the NCOA report will be handled by contracted staff.  Family Support Division (FSD) staff may see comments made by contracted staff in the eligibility system regarding an address change.  FSD staff continue to be responsible for returned mail showing an out of state address or indication that the participant is deceased.

The MO HealthNet for the Aged, Blind and Disabled manual section 0890.005.00 Unwinding the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) and the Family MO HealthNet (MAGI) manual section 1895.005.00 Unwinding the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) have been updated to add this memo.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/sh

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET (MHN) POLICY CHANGES FOR AUTHORIZED REPRESENTATIVES

MANUAL REVISION #
0110.060.15.10
0803.000.00
1801.000.00
1801.005.00
1801.010.00
1801.010.10
1801.010.20
1801.020.00
1801.030.00
1802.020.30
0803.020.05 obsolete
0803.020.10 obsolete
0803.020.10.10 obsolete
0803.020.10.20 obsolete
0803.020.10.30 obsolete
0803.020.30 obsolete

DISCUSSION:

MHN policy has been updated to provide clarifications for authorized representatives. Updates include:

• Changes to terms to use updated FSD terms.
• Corrections to formatting including section headings and easier to navigate bullet lists.
• Updating examples to be relevant for common questions.
• Clarifying policy that arises with Family MO HealthNet (MAGI) households that contain a mixture of household compositions and people receiving different types of coverage.

The updated authorized representative policy has been added to the Family MO HealthNet (MAGI) Manual. New MAGI section 1801.000.00 Authorized Representative(s) for MO HealthNet provides a link and a brief description of each section.

Additional new MAGI policy sections are:

• 1801.005.00 – Legal Basis
• 1801.010.00 – Appointing an Authorized Representative
• 1801.010.10 – Appointing an Authorized Representative in a Household with Multiple Adults
• 1801.010.20 – Appointing Another Adult Member of the Household as an Authorized Representative
• 1801.020.00 – Duration of Appointment of Representative
• 1801.030.00 – Revoking an Authorized Representative Appointment

Updates were made to the existing MAGI section, 1802.020.30 Signing by an Authorized Representative, to update terminology and update links.

General Information Manual section 0110.060.15.10 FCRA Authorization for MO HealthNet for Disabled Children (MHDC) Cases was revised to update a link to a new MAGI section.

MO HealthNet for the Aged, Blind, and Disabled (MHABD) policy section, 0803.000.00 Authorized Representative(s) for MO HealthNet, provides links to the Family MO HealthNet (MAGI) Manual as authorized representative policy is the same for both programs.

The following MHABD policy sections are now obsolete:

• 0803.020.05 – Legal Basis
• 0803.020.10 – Appointment of an Authorized Representative
• 0803.020.10.10 – Appointment of an Authorized Representative When There is a Spouse or Second Parent in the Eligibility Unit
• 0803.020.10.20 – Duration of the Appointment of Representative
• 0803.020.10.30 – Authorized Representative Revocation
• 0803.020.30 – Signing by an Authorized Representative

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• These updates replace all previous policy and guidance regarding authorized representatives.
• Send questions regarding authorized representatives through normal supervisory channels.

KE/cj

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET (MHN) REVIEW FORMS UPDATED

FORM REVISION #
IM-1U
FA-402
FA-402 Spanish

DISCUSSION:

Effective July 10, 2022 the MO HealthNet Eligibility Review Information (FA-402), Información Sobre la Revisión de la Elegibilidad para Acceder a MO HealthNet (FA-402 Spanish), and the MO HealthNet Eligibility Review (IM-1U) were updated to add required and helpful information for participants. The public and internal forms manuals were updated with the revised forms and the eligibility system has been updated to send the revised FA-402.

Updates to the FA-402 include:

• Adding or updating return information to include the new Family Support Division (FSD) Upload Portal website, myDSSupload.mo.gov
  • Individuals can use mydssupload.mo.gov to submit a variety of documents to FSD including, but not limited to, applications, reviews, changes, or supporting documents
  • This portal replaces the email address, FSD.documents@dss.mo.gov
• Adding the FSD Nondiscrimination statement
• Removing fields for Collateral Information which is no longer required for MHN
• Adding military status questions to determine if participants may be eligible for and interested in receiving resources available to veterans and their families
  • Question 1: Have you or an immediate family member ever served in the U.S. Armed Forces?
  • Question 2: If yes, would you like information about military-related services in Missouri?

NOTE: Answering these questions is optional and will NOT affect any benefits received from FSD.

Revisions were made to the IM-1U to replace the existing email address with the website address to the FSD Upload Portal. The revised form is available on the public and internal forms manuals.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/mc

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  FAMILY MO HEALTHNET (MAGI) MANUAL UPDATED WITH HEALTHCARE SHARING MINISTRY PLANS

MANUAL REVISION #
1840.010.10

DISCUSSION:

MAGI Manual section 1840.010.10 Uninsured was updated to include Healthcare Sharing Ministry Plans. This type of plan was added to the list of insurances that are not considered to be health care coverage.

An individual with a Healthcare Sharing Ministry Plan should be treated as uninsured when determining eligibility for CHIP, however, the plan should be reported for Third Party Liability (TPL).

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Review 1805.045.00 Third Party Liability (TPL).

KE/ams

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATE TO REASONABLE COMPATIBILITY POLICY IN THE FAMILY MO HEALTHNET (MAGI) MANUAL

MANUAL REVISION #
1805.030.15

DISCUSSION:

Effective immediately, when a participant attests to income above applicable program thresholds, the participant is ineligible. Participants determined to be ineligible are systematically referred to the Federally Facilitated Marketplace (FFM) to explore coverage.

MAGI Manual section 1805.030.15 Reasonable Compatibility is revised to add definitions of eligibility levels and program thresholds and to explain the distinction between the two.

For the duration of the Public Health Emergency (PHE), follow verification guidance in MEDES Resources.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  APPENDIX H UPDATED WITH NEW MEDICAID ELIGIBILITY (ME) CODES FOR CHILDREN’S DIVISION (CD)

MANUAL REVISION #
MAGI Appendix H

DISCUSSION:

Effective July 1, 2022, Appendix H of the Family MO HealthNet (MAGI) Manual is updated to include 2 new ME codes used by CD:

• 0F-Foster Care Title IV-E
• 5A-Adoption/Guardianship Subsidy Title IV-E

Neither coverage type is Title XIX funded; both are state funded.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers