Author: Patrick Ellison

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REASONABLE OPPORTUNITY, CITIZENSHIP, AND IMMIGRANT STATUS POLICY CONSOLIDATED FOR MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
1010.000.00
0110.020.00 obsolete
0110.020.01 obsolete
0110.020.02 obsolete
0110.020.03 obsolete
0110.020.05 obsolete
1010.005.00 obsolete
1010.010.00 obsolete

DISCUSSION:

Based on feedback recommendations, the 1973 Eligibility Requirements Manual has been updated to provide links to the Family MO HealthNet (MAGI) Manual sections regarding Reasonable Opportunity, Citizenship, and Immigration Status requirements that are the same for both programs. Links can be found in the renamed manual section, 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB).

Policy found in sections 1010.005.00 Documents to Verify Citizenship and 1010.010.00 Citizens of the Federated States of Micronesia, Republic of Palau, and Republic of Marshall Islands has been moved to 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB) and linked to the MAGI Manual; therefore, these section numbers are now obsolete.

The following Verification Requirements sections in the General Information manual are obsolete as the policy contained in these sections has also been moved to 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB) and linked to the MAGI Manual:

• 0110.020.00 Citizenship/Alien Status
• 0110.020.01 Documents to Verify Citizenship
• 0110.020.02 Reasonable Opportunity to Verify Citizenship
• 0110.020.03 Reapplication after Benefits are Discontinued for Failure to Provide Documentation of Citizenship
• 0110.020.05 Alien Status

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATES TO FAMILY MO HEALTHNET (MAGI) MANUAL SECTIONS ALLOWABLE DEDUCTIONS AND SPECIFIC TYPES OF INCOME

MANUAL REVISION #
1805.030.20.15
1805.030.25.15

DISCUSSION:

The Internal Revenue Service (IRS) has revised IRS Form-1040 and IRS Schedule 1 (Form-1040). MAGI manual sections 1805.030.20.15 Allowable Deductions and 1805.030.25.15 Specific Types of Income have been updated to remove references to the location of specific line items found on these forms.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/kg

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  CALCULATION OF THE FIVE PERCENT DISREGARD IN THE FAMILY MO HEALTHNET (MAGI) POLICY MANUAL REVISED

MANUAL REVISION #
1805.030.20.20.05

DISCUSSION:

Revisions were made to MAGI Manual section 1805.030.20.20.05 Calculation of the Five Percent Disregard. References to systematic calculations and examples containing these calculations have been removed.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ams

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  NEW CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) NON-PREMIUM LEVEL OF CARE, 4M

MANUAL REVISION #
1800.000.00
1805.030.15
1805.040.00
1840.010.00
1840.010.05
1840.015.00
1880.010.00
1885.000.00
MAGI Appendix A
MAGI Appendix D
MAGI Appendix H

DISCUSSION:

CHIP 4M Non-Premium is a new level of care (LOC) effective July 1, 2022 created for MO HealthNet Division (MHD) reporting requirements. CHIP 4M provides non-premium MO HealthNet coverage for uninsured children who meet the requirements at 1840.010.00 Eligibility Requirements in addition to the following:

Income

• Children ages 1 through 5: Gross income of 148% up to and including 153% FPL
• Children ages 6 through 18: Gross income of 110% up to and including 153% FPL

Family MO HealthNet (MAGI) Manual Appendix A and Appendix D are updated with this change.

Uninsured

• Children must be uninsured with no access to health insurance through a family member’s employment with a public agency.
• Children with disabilities who qualify for MO HealthNet for Disabled Children (MHDC) non-spend down are considered insured.

Children are eligible for MO HealthNet for Kids (MHK) Non-CHIP if they meet all eligibility factors for CHIP 4M, other than the uninsured requirement. Explore MHK coverage if a child on CHIP 4M becomes insured or otherwise fails to meet the uninsured requirements for the CHIP 4M group.

EXAMPLE: Shari, age 13, receives CHIP 4M coverage. Her household’s income is at 117% of FPL. Her mother reports that Shari is now receiving health insurance coverage through an employer. Shari’s coverage transitions to MHK Non-CHIP.

Do not close or reject CHIP 4M coverage for failure to provide information about insurance status for a child.

EXAMPLE: June is uninsured and is eligible for CHIP 4M coverage. Her father submits two applications, one on 7/1 and the other on 7/2. On the 7/1 application he declares that June has insurance through his employer. On the 7/2 application he declares that she is uninsured. Clarification of insurance status for June is requested, but her father does not respond. June remains eligible for CHIP 4M.

Eligibility for CHIP 4M begins the first day of the application month or in prior quarter if all eligibility requirements are met. Children eligible for CHIP 4M are eligible for Non-Emergency Medical Transportation (NEMT).

MXIX will display 4M in the LOC column, when applicable. MAGI Appendix H: ME Codes Chart is updated with CHIP 4M.

NOTE: Although 4M is CHIP, because its income guidelines overlap with non-CHIP, the assignment of medical support is mandatory. A Referral/Information for Child Support Services (CS201) is required unless good cause for refusal to cooperate is established. Refer to 1805.040.00 Cooperation in Pursuit of Medical Support.

The MAGI manual is updated with these changes.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REPLACEMENT OF MO HEALTHNET ELIGIBILITY CODES (ME) FOR CERTAIN SHOW ME HEALTHY BABIES (SMHB) NEWBORNS

MANUAL REVISION #
1855.030.05

DISCUSSION:

To simplify funding procedures for the SMHB program, the following ME codes for SMHB Newborns are updated, effective July 1, 2022:

• ME 62 with a Federal Grant Indicator (FGI) of 8 is replaced with ME 6S.
• ME 74 and 75 with an FGI of 8 are replaced with ME 9S.

SMHB Newborn eligibility requirements have not changed. These ME code changes apply to SMHB levels of care only.

Non-SMHB levels of care, including MHK Under 1 (ME 62) and CHIP Premium Groups 74 and 75 (ME 74 and 75), are not affected. ME 97, the ME code for SMHB Newborns born to mothers denied MO HealthNet for Pregnant Women (MPW) due to excess income, is not replaced or affected.

Appendix H is updated with this change.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATE TO CLARIFY MO HEALTHNET FOR FAMILIES (MHF) ELIGIBILITY FOR 18-YEAR-OLDS

MANUAL REVISION #
1810.020.20.20

DISCUSSION:

Family MO HealthNet (MAGI) Manual section 1810.020.20.20 Eligibility for 18-Year-Olds is updated to clarify educational requirements for children who have reached the age of 18, but have not reached the age of 19.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ams